Devenir à moyen terme de 70 syndromes de Tako-Tsubo

Abstract

BackgroundTako-Tsubo syndrome is a reversible left ventricular myocardial dysfunction. There are few publications on its evolution and the purpose of this study is to describe the medium-term outcome of patients who presented this pathology. MethodsThis retrospective study included 70 patients presenting with Tako-Tsubo syndrome who were referred to Haut-Lévèque hospital between November 2003 and January 2012. The parameters included in follow-up were: number of cardiovascular events, recurrence, electrocardiographic and echocardiographic evolution. ResultsSixty-eight patients had a mean follow-up of 4.8±2.4 years. The survival rate was 92%, 39 patients (57%) showed no cardiovascular symptoms, 12 (18%) had one or more new episodes of chest pain and 4 (6%) had stage II dyspnoea on the NYHA classification scale. One patient had a recurrence 6.5 years later, triggered by the same stress as the first instance. Forty-five patients (64%) had ECGs which evolved in the early days to diffuse T-wave inversion. In the medium term, 32 (54%) patients had a normal ECG, 19 (32%) had inverted T-waves in precordial leads and 2 (3%) had Q-waves. In terms of echocardiography, left ventricular ejection fraction was normal in all with variable delays. Four patients continued to have apical hypokinesia. ConclusionThis study shows that the medium-term outlook is favourable in terms of cardiovascular mortality and that recurrence is rare. It highlights, however, the persistence of electrocardiographic and echocardiographic abnormalities.