title: Impact of right ventricular involvement on the prognosis of takotsubo cardiomyopathy.
abstract: BACKGROUND
  Previous studies showed that patients with takotsubo cardiomyopathy had a higher long-term mortality rate than the general population and the incidence of in-hospital complications was higher in takotsubo cardiomyopathy with than without right ventricular (RV) involvement. This study was performed to investigate the long-term prognostic impact of RV involvement in takotsubo cardiomyopathy.
  
  
  RESULTS
  The clinical data of 113 patients (72.7 ± 11.4 years old, 84 females) with takotsubo cardiomyopathy were studied retrospectively. The patients were divided into two groups according to the presence (biventricular group, n = 21, 18.6%) or absence (classical group, n = 92, 81.4%) of RV involvement assessed by initial echocardiography. The end point was a composite of all-cause death, re-hospitalization due to heart failure, and recurrence of takotsubo cardiomyopathy. The in-hospital mortality rate was significantly higher in the biventricular group than the classical group (14.3 vs. 1.1%, respectively, P = 0.02). Kaplan-Meier analysis indicated a significantly lower event-free survival rate in the biventricular group than the classical group (log-rank, P < 0.001). On multivariate analysis, RV involvement was the only independent predictor of the end point (HR: 2.73, P = 0.026).
  
  
  CONCLUSIONS
  The rates of in-hospital and long-term events were significantly higher in takotsubo cardiomyopathy with than without RV involvement, and RV involvement was the independent predictor of the poor prognosis.
authors.affiliation: The Sakakibara Heart Institute of Okayama Okayama, 2-5-1, Nakaicho, Kitaku, Okayama 700-0804, Japan kgnb_27_hot@yahoo.co.jp.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kagiyama
authors.affiliation: Kawasaki Medical School, Kurashiki, Japan First Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okura
authors.affiliation: Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tamada
authors.affiliation: Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Imai
authors.affiliation: Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Yamada
authors.affiliation: Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Kume
authors.affiliation: The Sakakibara Heart Institute of Okayama Okayama, 2-5-1, Nakaicho, Kitaku, Okayama 700-0804, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hayashida
authors.affiliation: Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Neishi
authors.affiliation: Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kawamoto
authors.affiliation: The Sakakibara Heart Institute of Okayama Okayama, 2-5-1, Nakaicho, Kitaku, Okayama 700-0804, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy
keywords: cardiomyopathy; echocardiography; prognosis