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Left Ventricular Ballooning Patterns in Recurrent Takotsubo Cardiomyopathy: A Systematic Review and Meta-analysis of
Ravi Korabathina1,2, Jamie Porcadas3, Kevin E Kip4
1Department of Cardiovascular Medicine, Bayfront Health, St. Petersburg, Florida.
Texas Heart Institute Journal
|December 13, 2021
Summary
Recurrent takotsubo cardiomyopathy (TTC) outcomes differ by left ventricular ballooning pattern. Atypical patterns are linked to fewer severe adverse events and better survival compared to typical apical patterns in recurrent TTC patients.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Recurrent takotsubo cardiomyopathy (TTC) and its clinical impact remain incompletely understood.
- The influence of left ventricular (LV) ballooning patterns on recurrent TTC outcomes requires further investigation.
Purpose of the Study:
- To evaluate clinical profiles and outcomes of patients with recurrent TTC.
- To compare outcomes based on left ventricular ballooning patterns during recurrence.
Main Methods:
- Systematic literature search identifying 101 cases of recurrent TTC from 84 articles.
- Classification of cases into typical (apical ballooning only) and atypical (midventricular or basal ballooning) groups.
- Comparison of demographic characteristics, triggers, treatments, and clinical outcomes between the two groups.
Main Results:
- The atypical group (n=41) experienced significantly fewer severe adverse events (cardiogenic shock, cardiac arrest) compared to the typical group (n=60) (adjusted odds ratio=0.37).
- Survival to hospital discharge was higher in the atypical group (96%) versus the typical group (88.3%).
- Demographics, triggers, medications, ECG changes, and recovery times were similar between groups.
Conclusions:
- Left ventricular ballooning patterns significantly influence clinical outcomes in recurrent TTC.
- Patients with atypical LV ballooning patterns exhibit more favorable outcomes, including reduced severe adverse events and improved survival.
