Focal Takotsubo syndrome: Clinical features and outcomes

Area of Science:

• Cardiology
• Cardiovascular Research
• Medical Imaging

Background:

• Takotsubo syndrome (TTS) typically presents with apical ballooning.
• Focal forms of TTS are sporadically reported and lack comprehensive characterization.
• Understanding focal TTS is crucial for complete diagnosis and management.

Purpose of the Study:

• To comprehensively evaluate the clinical features of focal TTS.
• To assess the prognostic profile of focal TTS compared to classical phenotypes.
• To characterize this rare entity within the TTS spectrum.

Main Methods:

• Analysis of 3722 patients from the GEIST registry (NCT04361994).
• Identification of focal TTS cases using segmental wall motion abnormalities and cardiac magnetic resonance.
• Comparison of clinical, laboratory, and imaging data, including in-hospital and long-term outcomes.

Main Results:

• Focal TTS accounted for 1.2% of cases (n=43) and presented in younger patients with higher LVEF.
• Emotional triggers were more frequent in focal TTS (51%) compared to classical forms (35%).
• Focal TTS patients had lower NT-proBNP levels and fewer in-hospital complications (9% vs 23%), but comparable long-term mortality.

Conclusions:

• Focal TTS is a rare, underrecognized variant of Takotsubo syndrome.
• Despite lower initial complication rates, long-term surveillance for focal TTS is essential.
• Further research is needed to fully understand the implications of focal TTS.