title: Characteristics and mid-term follow-up of a single-center population affected by Tako-Tsubo cardiomyopathy.
abstract: BACKGROUND
  Tako-Tsubo cardiomyopathy (TTC) is an acute cardiomyopathy mimicking acute myocardial infarction. The aim of our study was to define clinical and instrumental features of an Italian population of patients with TTC and to report their short and mid-term outcome.
  
  
  METHODS
  We retrospectively evaluated 42 patients admitted to our Department with diagnosis of TTC (100% women, age 67 ± 11 years) using Mayo Clinic-modified criteria. In this population, we analyzed the stressful event (if present), the clinical presentation, the ECG and echocardiogram at admission and the markers of myocardial cytonecrosis, such as troponin I, at admission and during the hospitalization. All the patients have been clinically evaluated after 6 months and 1 year of follow-up.
  
  
  RESULTS
  In this population, a stressful event before TTC has been detected in 59% of patients. The most common clinical presentation was chest pain (81%) and the major sign was dyspnea (17%). ECG showed negative T waves and ST elevation, respectively, in 45 and 38%. Only 10% had a ST depression and 7% developed a newly acquired complete left bundle branch block. All of these abnormalities disappeared within 1.8 ± 0.9 days. The mean ejection fraction at admission was 35 ± 7% associated with apical (40%), mid-apical (56%) and mid-ventricular (4%) wall motion abnormalities. The recovery of these abnormalities occurred within 10 ± 3 days. At 6-month and 1-year follow-up, no patients had TTC recurrence, and 10 patients at 6 months and 20 patients at 1 year were re-hospitalized for a non-cardiac cause.
  
  
  CONCLUSIONS
  Our data describe the characteristics of TTC in a small Italian population, which are similarly described in Japanese and North American people. TTC was related to a very low mortality, both in the short and mid term, but the risk of acute heart failure in the acute phase could not be neglected.
authors.affiliation: Department of Medical and Surgical, Radiological Sciences and Public Health Specialty, Section of Cardiovascular Diseases, University of Study of Brescia, Brescia, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizzardi
authors.forename: Ivano
authors.initials: I
authors.lastname: Bonadei
authors.forename: Riccardo
authors.initials: R
authors.lastname: Rovetta
authors.forename: Edoardo
authors.initials: E
authors.lastname: Sciatti
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Aloia
authors.forename: Natalia
authors.initials: N
authors.lastname: Pezzali
authors.forename: Francesca
authors.initials: F
authors.lastname: Salghetti
authors.forename: Antonio
authors.initials: A
authors.lastname: Curnis
authors.forename: Marco
authors.initials: M
authors.lastname: Metra
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D013312:Stress, Physiological; D013315:Stress, Psychological / Q000150:complications; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D015415:Biomarkers