title: Tako-tsubo syndrome and heart failure: long-term follow-up.
abstract: OBJECTIVE
  Tako-tsubo syndrome produces a variable degree of transient left ventricular dysfunction. Our objective was to determine the short- and long-term prognosis of this syndrome, the incidence of and risk factors for the development of heart failure, and the influence on heart failure on the long-term outcome in our patient population.
  
  
  METHODS
  We prospectively recorded the clinical features and events during the hospital stay and follow-up of 100 patients with tako-tsubo syndrome. The risk factors for heart failure during hospital stay, considered as Killip class≥II, were assessed.
  
  
  RESULTS
  Most of the patients were women (89%), with a mean age of 68 years. The distribution according to Killip class was: Killip I, 70 patients; Killip II, 15; Killip III, 5; and Killip IV, 10. Cardiovascular risk factors, including diabetes, were common in the overall group, but were more so in the heart failure cohort. The left ventricular ejection fraction was lower in the heart failure group (51% vs 42%; P<.01). There were no differences in preadmission medications or biomarkers of necrosis. Over a median follow-up of 1380 days, the incidence of events reported during the hospital stay and long-term follow-up, both for death and the combined endpoints, was higher in the heart failure cohort.
  
  
  CONCLUSIONS
  Although the prognosis in tako-tsubo syndrome is usually good, heart failure occurs quite frequently, mainly in patients with a greater number of comorbidities and poorer previous functional class. Moreover, heart failure is associated with a higher number of early and late adverse events. The overall long-term prognosis is good. Full English text available from:www.revespcardiol.org.
authors: Unidad Coronaria, Cardiología Intervencionista e Imagen Cardiovascular, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain. ibnsky@yahoo.es
authors: Iván J
authors: IJ
authors: Núñez-Gil
authors: María
authors: M
authors: Molina
authors: Esther
authors: E
authors: Bernardo
authors: Borja
authors: B
authors: Ibañez
authors: Borja
authors: B
authors: Ruiz-Mateos
authors: Juan C
authors: JC
authors: García-Rubira
authors: David
authors: D
authors: Vivas
authors: Gisela
authors: G
authors: Feltes
authors: María
authors: M
authors: Luaces
authors: Joaquín
authors: J
authors: Alonso
authors: José
authors: J
authors: Zamorano
authors: Carlos
authors: C
authors: Macaya
authors: Antonio
authors: A
authors: Fernández-Ortiz
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009336:Necrosis; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left