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Apical sparing in tako-tsubo cardiomyopathy.
Internal Medicine Journal
|June 20, 2006
Summary
The apical sparing variant of tako-tsubo cardiomyopathy (TTC) is common, affecting 40% of patients. This variant typically presents in younger, premenopausal women but shares similar outcomes with the classical form.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Clinical Research
Background:
- Tako-tsubo cardiomyopathy (TTC) is an acute, reversible condition causing segmental myocardial dysfunction.
- A variant form of TTC exhibits apical sparing, where a small apex segment retains contractile function.
- The clinical differences and frequency of this variant compared to the classical form are not well understood.
Purpose of the Study:
- To determine the frequency of the apical sparing variant of TTC.
- To compare the clinical characteristics of patients with the apical sparing variant versus the classical form of TTC.
Main Methods:
- A cohort of 35 TTC cases was identified from an infarct angiography database.
- Cases were categorized into apical sparing (n=14) and no apical sparing (n=21) groups.
- Clinical data including age, menopausal status, and ejection fraction were compared between groups.
Main Results:
- The apical sparing variant accounted for 40% of TTC cases.
- Patients with apical sparing were significantly younger (63 vs 72 years) and more likely premenopausal (5/14 vs 0/21).
- Higher ejection fractions (35% vs 32%) and a trend towards higher recurrence were observed in the apical sparing group, with no differences in other clinical parameters.
Conclusions:
- The apical sparing variant of TTC is a common presentation, seen in 40% of cases.
- This variant is associated with younger age and premenopausal status.
- Despite demographic differences, there are no other significant distinguishing clinical features between the classical and apical sparing forms of TTC.