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Systolic function predictors in patients with Takotsubo Syndrome
Session:
SESSÃO DE POSTERS 28 - ECOCARDIOGRAFIA DE STRESS
Speaker:
Maria Leonor Moura
Congress:
CPC 2025
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.2 Myocardial Disease – Epidemiology, Prognosis, Outcome
Session Type:
Cartazes
FP Number:
---
Authors:
Maria Leonor Moura; Marta Catarina Almeida; Francisca Rafaela Nunes; Francisco Lemos de Sousa; Inês Arrobas Rodrigues; António Gonçalves; André Lobo; Marta Leite; Inês Neves; Olga Sousa; Rita Faria; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Background: </strong>Takotsubo syndrome (TS) is characterized by segmental systolic dysfunction. Usually, but not always, systolic disfunction is transitory.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Purpose: </strong>This study aims to characterize global systolic function (SF) predictors in patients with TS.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Methods: </strong>This retrospective study analysed patients with diagnosis of TS between 2018 and 2024 admitted in a cardiology unit. SF at admission, at discharge and at revaluation was registered. Normal SF was considered when left ventricular ejection fraction was equal to or above 55%. Comorbidities, ST segment elevation, QT duration, apical ballooning on admission, edema on cardiac magnetic resonance imaging (CMR) and evolution of cardiac and inflammatory biomarkers during hospitalization were collected. Kruskal-Wallis, Mann-Whitney and Chi-Square tests were used to test the correlations. Logistic regression was used to predict systolic disfunction at discharge.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Results:</strong> The study enrolled 74 patients with a median age of 69,5 [19] years and 62 (83,8%) females. At admission, 21 patients (28,4%) had normal SF and 49 (66,2%) reduced SF [4 (5,4%) missing]. Patients with reduced SF tended to have higher levels of C-reactive protein (CRP) at admission (p=0,016) and a higher maximum level of high sensitivity troponin (MT) (p=0,004). At discharge, 28 patients (37,9%) maintained an abnormal cardiac function. Reduced SF at discharge was associated with history of cardiomyopathy (p=0,023), higher levels of troponin at admission (AT) (p=0,047) and MT (p<0,001) and apical ballooning on echocardiogram at admission (p=0,026). Reduced SF at discharge was predicted (R<sup>2</sup> 0,782, p=0,012) by SF at admission (p=0,021), AT (p=0,013), MT (p<0,001), NTproBNP (p=0,029) and apical ballooning at admission (p=0,011). SF was reevaluated in 48 patients and only 5 patients (6,9%) had systolic dysfunction. Reduced SF after discharge was associated with lower levels of AT (p=0,048), smoking (p=0,027) and history of ischemic cardiopathy (p=0,010). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong>Conclusion: </strong>In this study, there was a low prevalence of abnormal SF in patients with TS. Cardiac biomarkers (troponin and NTproBNP) and CRP were associated with systolic dysfunction. Apical ballooning was also associated with systolic disfunction at discharge and during follow-up. This highlights the importance of considering laboratorial biomarkers, as well as identifying patients with apical ballooning at admission, since these TS patients are more likely to have reduced SF.</span></span></p>
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