Takotsubo cardiomyopathy, clinical experience with the disease and one-year prognosis of patients


Authors: Petr Kubena 1;  Šárka Bohatá 2;  Jan Maňoušek 1;  Jindřich Špinar 1,3;  Jiří Pařenica 1,3
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC 1;  Radiologická klinika LF MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Vlastimil A. Válek, CSc., MBA 2;  Mezinárodní centrum klinického výzkumu – Klinika kardiovaskulárních onemocnění FN u sv. Anny Brno, ředitel Gorazd B. Stokin, M. D., MSc., Ph. D. 3
Published in: Vnitř Lék 2015; 61(7-8): 619-625
Category: Original Contributions

Overview

Introduction:
Takotsubo cardiomyopathy (TCM) is a rare cardiac disease. In the acute phase it may imitate acute myocardial infarction of the anterior wall with ST elevations. This can be complicated by ventricular fibrilation or heart failure. The aim of this study is to show the characteristics of patients with takotsubo cardiomyopathy, the one year outcome and the application of magnetic resonance imaging of the heart in the diagnosis of this disease.

Methods:
Forty seven patients with takotsubo cardiomyopathy were enrolled in this study. Severe stenosis of coronary arteries was excluded by selective coronarography. In twelve patients the magnetic resonance imaging of the myocardium was performed. The patients were observed for at least 12 months.

Results:
89.4 % of takotsubo patients were women. Average of age was 62.3 ± 11.1 years. We found obvious stress factors in 18 patients (38.3 %). Many patients suffered from thyroid disorders, psychiatric, lung or allergic diseases. Thirty nine patients (83.0 %) had the apical and eight the midventricular type of takotsubo cardiomyopathy. In 42 patients (89.4 %) developed systolic left ventricular dysfunction and four patients (8.5 %) were in cardiogenic shock. Four patients (8.5 %) manifested ventricle fibrilation. One patient (2.1 %) had recurring takotsubo cardiomyopathy.

Conclusion:
Left ventricle function is mostly recovered in patients with takotsubo cardiomyopathy, but the acute phase can be complicated by cardiogenic shock or ventricular fibrilation. Magnetic resonance imaging of the heart is indicated in some patients to differentiate this cardiomyopathy from ischemic or inflammatory etiology.

Key words:
magnetic resonance imaging of the heart – prognosis – takotsubo cardiomyopathy


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Labels
Diabetology Endocrinology Internal medicine

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