Abstract 14988: Clinical Impact of Biventricular vs. Isolated Left Ventricular Involvement Among Patients With Takotsubo Cardiomyopathy- An Updated Meta-Analysis

Abstract

Introduction: Takotsubo Cardiomyopathy (TC) is a form of acute nonischemic cardiomyopathy manifesting as a transient state of cardiac dysfunction. Isolated left ventricular TC (ILVTC) is most commonly observed, less frequently, superimposed right ventricular involvement is apparent - referred to as biventricular TC (BVTC). Few analyses have been done to characterize the implications of biventricular TC on hospital courses and outcomes. Methods: A literature search was conducted on PubMed and Google Scholar to identify qualifying studies. Inclusion criteria were adult patients with TC, and studies reporting comparison of outcomes (cardiogenic shock, use of inotropes, all causes of mortality, and length of hospital stay) between patients with BVTC and ILVTC. Exclusion criteria were any studies that reported on patients younger than 18 years or did not report all the outcomes for BVTC vs ILVTC. Results: A total of 1,156 patients with TC were analyzed from 6 included studies, of which 15% had BVTC (n=175), and 85% had ILVTC (n=981). Patients with BVTC were found to have a higher incidence of cardiogenic shock patients (OR:3.3; 95% CI=1.40-7.77) and use of inotropes (OR:3.66; 95% CI =1.60-8.35). All-cause mortality did not reach statistical significance between the two groups (OR:2.05; 95% CI=0.81 - 5.22; p <0.13). There was also no significant difference in length of hospital stay (Hedges’ g = 0.22; 95% CI = -0.01 to +0.45; p = 0.0593). Conclusions: In comparison to ILVTC, BVTC increasingly predisposes to cardiogenic shock development. Yet, the presence of biventricular involvement does not impact the risk of mortality or hospital length of stay when compared to ILVTC.