PS 14-19 TAKO-TSUBO CARDIOMYOPATHY

Abstract

Objective: Tako-tsubo cardiomyopathy (TTC) is characterized by reversible left ventricular dysfunction, frequently precipitated by a stressful event. Despite the favorable course and good long-term prognosis, a variety of complications may occur in the acute phase of the disease. The aim of this study was to evaluate the in-hospital and long-term outcomes of a cohort of TTC patients. Design and Method: Fifty-five patients (mean age 68.1+/-12 years) were prospectively followed for a mean of 69.6+/-32.2 months (6–4635 days). In-hospital (death, heart failure, arrhythmias) and long-term events (death and recurrences) were recorded. Results: Patients were predominantly women (87.3%) who experienced a recent stressful event (emotional or physical) and were admitted to hospital for chest pain. Eleven patients (20%) had a diagnosis of depressive disorder, and arterial hypertension was the most frequent cardiovascular risk factor. The ECG revealed ST-segment elevation in 43.6% of patients. At angiography, 7 cases (12.7%) had at least one significant (ò50%) coronary artery stenosis and 4 patients (7.3%) had myocardial bridging of the left anterior descending artery. During hospitalization, 3 patients died (one from cardiac causes) and cardiovascular complications occurred in 12 patients. During follow-up, 5 patients died (none from cardiac causes), 6 patients had recurrences within the first year. Two patients had two recurrences: one after 114 days, triggered by an asthma attack as the first event, and the other after 1850 days. Conclusions: In TTC patients, in-hospital and long-term mortality is primarily due to noncardiovascular causes. Recurrences are not infrequent and coronary artery disease is not an uncommon finding.