Abstract
Takotsubo syndrome (TTS) is an intriguing clinical entity, characterized by usually transient and reversible abnormalities of the left ventricular systolic function, mimicking the myocardial infarction with non-obstructive coronary arteries. TTS was initially regarded as a benign condition, however recent studies have unveiled adverse outcomes in the short- and long-term, with rates of morbidity and mortality comparable to those experienced after an acute myocardial infarction. Given the usual transient nature of TTS, this is an unexpected finding. Moreover, long-term mortality seems to be mainly driven by non-cardiovascular causes. The uncertain long-term prognosis of TTS warrants a comprehensive outpatient follow-up after the acute event, although there are currently no robust data indicating its modality and timing. The aim of the present review is to summarize recent available evidence regarding long-term prognosis in TTS. Moreover methods, timing and findings of the long-term management of TTS will be discussed.
Highlights
Takotsubo syndrome (TTS) is defined as an acute and usually reversible heart failure syndrome, characterized by typical and transient regional wall motion abnormalities of left ventricle (LV) that reflect impairment of myocardial contractility without the evidence of culprit epicardial coronary artery lesions [1]
During the acute phase of TTS, hemodynamic and electrical instability may be the cause of serious adverse in-hospital complications, such as acute heart failure, arrhythmias and thromboembolic events, which occur in approximately one-fifth of TTS patients [6, 7]
Despite substantial recovery of left ventricular ejection fraction (LVEF) in the chronic phase, worse prognosis in the long-term has been detected in those patients having a higher degree of cardiac dysfunction during the acute event [24, 25]
Summary
Takotsubo syndrome (TTS) is defined as an acute and usually reversible heart failure syndrome, characterized by typical and transient regional wall motion abnormalities of left ventricle (LV) that reflect impairment of myocardial contractility without the evidence of culprit epicardial coronary artery lesions [1]. The prevalence of TTS is currently reported to be around 2%–3% among patients presenting with suspected acute coronary syndrome (ACS) [5]. While the short-term prognosis and acute management of TTS have been extensively characterized by several studies, data on long-term outcomes are less well defined. In the present review we will summarize and discuss the most recent evidences regarding long-term prognosis in TTS. Methods, timing and findings of the outpatient follow-up after the in-hospital phase of TTS will be discussed
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