Clinical and echocardiographic course in tako-tsubo cardiomyopathy: Long-term follow-up from a multicenter study
Javier Matabuena Gomez-Limon1, Sebastian Isaza Arana1, Juan Robledo-Carmona2
1Cardiovascular Imaging Laboratory and Biomedicine Institute of Seville (IBiS), Virgen del Rocio University Hospital, Seville, Spain.
Insights
Long-term follow-up of tako-tsubo cardiomyopathy (TC) patients shows most remain asymptomatic with minimal cardiac abnormalities. Recurrence of TC events is the primary long-term cardiovascular concern.
Area of Science:
- Cardiology
- Internal Medicine
- Cardiovascular Research
Background:
- Tako-tsubo cardiomyopathy (TC), also known as stress-induced cardiomyopathy, is a transient cardiac dysfunction.
- Understanding the long-term clinical trajectory and outcomes of TC patients is crucial for patient management.
Purpose of the Study:
- To comprehensively describe the long-term clinical characteristics, electrocardiogram (ECG) and echocardiographic findings.
- To evaluate adverse cardiovascular events in patients following an initial TC event.
Main Methods:
- A longitudinal multicenter study involving retrospective analysis of clinical and ECG data.
- Follow-up evaluations included clinical interviews, ECGs, and echocardiograms to assess long-term status.
Main Results:
- Most patients (97%) were asymptomatic or mildly symptomatic at long-term follow-up (median 3.7 years).
- ECG abnormalities resolved in 87% of patients; left ventricular ejection fraction remained preserved (mean 63±6%).
- Recurrence of TC occurred in 8% of patients, representing the most significant long-term cardiovascular adverse event.
Conclusions:
- Patients with TC generally experience a favorable long-term prognosis, remaining asymptomatic or minimally symptomatic.
- Long-term cardiac function and ECG findings typically show significant improvement or normalization.
- Recurrence of TC is the most prominent cardiovascular adverse event requiring monitoring.
Objectives:
To jointly describe clinical characteristics, ECG and echocardiographic findings, and adverse cardiovascular events in patients with tako-tsubo cardiomyopathy (TC) in the long-term.
Methods:
Longitudinal multicenter study including retrospective analysis of clinical and ECG data, and follow-up evaluation with clinical interview, electrocardiogram and echocardiogram.
Results:
Data from 66 cases of TC were available for analysis of clinical and adverse cardiovascular events, and 56 of them completed the follow-up visit including electrocardiogram and echocardiogram. Most patients (97%) were asymptomatic or oligosymptomatic (NYHA I [58%] or II [39%], respectively) at follow-up (median time: 3.7 [1.8-6.6] years). The vast majority of individual QRS complex and repolarization abnormalities had disappeared (87% with no ECG abnormalities at follow-up). On echocardiography, left ventricular ejection fraction was ≥50% in all patients (mean: 63±6%). Wall motion abnormalities were observed in 4 patients (7%; 3 with apical wall motion abnormalities and 1 with mild global hypokinesia). Long-term outcomes were as follows: 4 deaths (6%), 2 cardiovascular and 2 non-cardiovascular; no atrial fibrillation development; no stroke events; 5 acute recurrence events of TC (8%). Globally, 57 patients (86%) had a clinical course free from adverse cardiovascular events.
Conclusions:
After a long period following the admission event, patients discharged from TC remain asymptomatic or minimally symptomatic, and feature a low prevalence of both ECG and left ventricular wall motion abnormalities; moreover, the latter lead to a very mild impairment of ejection fraction. Among cardiovascular adverse events, recurrence of the TC event appears to play the most significant role.
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