title: Short and long-term outcome of stress-induced cardiomyopathy: what can we expect?
abstract: BACKGROUND
  Stress-induced/Takotsubo cardiomyopathy (TC) is an increasingly recognized diagnostic entity.
  
  
  OBJECTIVE
  This study was aimed to assess the prevalence and clinical predictors of short and long-term outcome of patients (pts) diagnosed with TC.
  
  
  METHODS
  We included all consecutive pts admitted in our department, from November 2006 to August 2011, who met the Mayo Clinic criteria for TC diagnosis.
  
  
  RESULTS
  We evaluated 37 pts (35 women) with a mean age of 63 ± 13 years. TC was precipitated by a stressful emotional event in the majority (57%) and chest pain was the most common symptom (89%). Twelve pts (32%) had ST-segment elevation and 15 pts (41%) had T-wave inversion on the electrocardiogram at admission. Severe left ventricular (LV) dysfunction was found in 16 pts (43%) and the mean troponin I level was 2.6 ± 1.8 ng/mL. The in-hospital complication rate was 30%, with cardiogenic shock being the most common situation. Physical stress, severe LV systolic dysfunction and peak brain natriuretic peptide (BNP) were predictors of acute complications. On the other hand, we found no association between peak troponin I and electrocardiographic presentation. Thirty-five pts were followed for a mean time of 482 ± 512 days, without clinic recurrence.
  
  
  CONCLUSIONS
  In our cohort of pts, TC was associated with a high in-hospital complications rate. Physical stress, LV dysfunction and peak BNP could predict acute adverse outcomes.
authors.affiliation: Centro Hospitalar São João, Porto, Portugal.
authors.forename: Vânia Filipa Andrade
authors.initials: VF
authors.lastname: Ribeiro
authors.affiliation: Centro Hospitalar São João, Porto, Portugal.
authors.forename: Mariana
authors.initials: M
authors.lastname: Vasconcelos
authors.affiliation: Centro Hospitalar São João, Porto, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Melão
authors.affiliation: Centro Hospitalar São João, Porto, Portugal.
authors.forename: Ester
authors.initials: E
authors.lastname: Ferreira
authors.affiliation: Hospital Pedro Hispano, Porto, Portugal.
authors.forename: Gracieta
authors.initials: G
authors.lastname: Malangatana
authors.affiliation: Hospital Pedro Hispano, Porto, Portugal.
authors.forename: Maria Júlia
authors.initials: MJ
authors.lastname: Maciel
mesh_terms: D000368:Aged; D003971:Diastole / Q000502:physiology; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000503:physiopathology*; D013318:Stroke Volume; D013599:Systole / Q000502:physiology; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000503:physiopathology*; D014336:Troponin / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
chemical_list: D014336:Troponin