Apical sparing in tako-tsubo cardiomyopathy

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.