title: Clinical and echocardiographic course in tako-tsubo cardiomyopathy: Long-term follow-up from a multicenter study.
abstract: OBJECTIVE
  To jointly describe clinical characteristics, ECG and echocardiographic findings, and adverse cardiovascular events in patients with tako-tsubo cardiomyopathy (TC) in the long-term.
  
  
  METHODS
  Longitudinal multicenter study including retrospective analysis of clinical and ECG data, and follow-up evaluation with clinical interview, electrocardiogram and echocardiogram.
  
  
  RESULTS
  Data from 66 cases of TC were available for analysis of clinical and adverse cardiovascular events, and 56 of them completed the follow-up visit including electrocardiogram and echocardiogram. Most patients (97%) were asymptomatic or oligosymptomatic (NYHA I [58%] or II [39%], respectively) at follow-up (median time: 3.7 [1.8-6.6] years). The vast majority of individual QRS complex and repolarization abnormalities had disappeared (87% with no ECG abnormalities at follow-up). On echocardiography, left ventricular ejection fraction was ≥50% in all patients (mean: 63±6%). Wall motion abnormalities were observed in 4 patients (7%; 3 with apical wall motion abnormalities and 1 with mild global hypokinesia). Long-term outcomes were as follows: 4 deaths (6%), 2 cardiovascular and 2 non-cardiovascular; no atrial fibrillation development; no stroke events; 5 acute recurrence events of TC (8%). Globally, 57 patients (86%) had a clinical course free from adverse cardiovascular events.
  
  
  CONCLUSIONS
  After a long period following the admission event, patients discharged from TC remain asymptomatic or minimally symptomatic, and feature a low prevalence of both ECG and left ventricular wall motion abnormalities; moreover, the latter lead to a very mild impairment of ejection fraction. Among cardiovascular adverse events, recurrence of the TC event appears to play the most significant role.
authors.affiliation: Cardiovascular Imaging Laboratory and Biomedicine Institute of Seville (IBiS), Virgen del Rocio University Hospital, Seville, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Matabuena Gomez-Limon
authors.affiliation: Cardiovascular Imaging Laboratory and Biomedicine Institute of Seville (IBiS), Virgen del Rocio University Hospital, Seville, Spain.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Isaza Arana
authors.affiliation: Unit of Clinical Management of Cardiology, Biomedicine Institute of Malaga (IBIMA), Cardiovascular Research Network (RIC) and University of Malaga, Virgen de la Victoria University Hospital, Malaga, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Robledo-Carmona
authors.affiliation: Non-invasive Cardiology Department, Cardiology Division, Jaen Medical Center, Jaen, Spain.
authors.forename: Edgar
authors.initials: E
authors.lastname: Alania Torres
authors.affiliation: Non-invasive Cardiology Department, Cardiology Division, Jaen Medical Center, Jaen, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Torres Llergo
authors.affiliation: Cardiovascular Imaging Laboratory and Biomedicine Institute of Seville (IBiS), Virgen del Rocio University Hospital, Seville, Spain.
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Valle-Racero
authors.affiliation: Cardiovascular Imaging Laboratory and Biomedicine Institute of Seville (IBiS), Virgen del Rocio University Hospital, Seville, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez Pardo
authors.affiliation: Cardiovascular Imaging Laboratory and Biomedicine Institute of Seville (IBiS), Virgen del Rocio University Hospital, Seville, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Martinez-Martinez
authors.affiliation: Unit of Clinical Management of Cardiology, Biomedicine Institute of Malaga (IBIMA), Cardiovascular Research Network (RIC) and University of Malaga, Virgen de la Victoria University Hospital, Malaga, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Jimenez-Navarro
authors.affiliation: Cardiovascular Imaging Laboratory and Biomedicine Institute of Seville (IBiS), Virgen del Rocio University Hospital, Seville, Spain. Electronic address: jaurbanomoral@gmail.com.
authors.forename: Jose Angel
authors.initials: JA
authors.lastname: Urbano-Moral
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases / Q000453:epidemiology; D004452:Echocardiography / Q000379:methods / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D000069451:Long Term Adverse Effects / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012008:Recurrence; D013030:Spain / Q000453:epidemiology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D016277:Ventricular Function, Left
keywords: Echocardiography; Electrocardiography; Prognosis; Systolic function; Tako-tsubo cardiomyopathy