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A. Basics
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01. History of Cardiology
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05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
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29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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34. Public Health and Health Economics
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Different triggers in patients of Takotsubo Cardiomyopathy – a different prognosis?
Session:
Posters 1 - Écran 10 - Miocárdio e Pericárdio
Speaker:
Liliana Rafaela Teles Reis
Congress:
CPC 2018
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.1 Myocardial Disease – Pathophysiology and Mechanisms
Session Type:
Posters
FP Number:
---
Authors:
Liliana Reis; João De Sousa Bispo; Luís Abreu; Margarida Oliveira; Ana Almeida; Rui Pontes Dos Santos; Maria João Matos Vieira; Catarina Ruivo; Ana Marreiros; Olga Azevedo
Abstract
<p><strong>Introduction:</strong> Takotsubo Cardiomyopathy (TC) is characterized by a transient left ventricular (LV) dysfunction and usually mimics an acute coronary syndrome. Despite the generally favorable prognosis, several clinics forms have been reported. Our aim was to assess if different stressful triggers had prognostic influence on TC and to establish a working classification.</p> <p><strong>Methods:</strong> A Portuguese multicenter study involving 12 hospitals with inclusion of all patients diagnosed with TC in the last 11 years. We evaluated demographic, clinical, electrocardiographic and echocardiographic data. We study 238 patients and in 148 of them was possible to identified a possible stressful trigger. Regarding the type of triggers we divide the population in group 1 (G1, N=104, 70%): emotional stress and group 2 (G2, N=44, 30%) physical factors (surgery, trauma, etc). The clinical endpoints of interest were acute heart failure, recurrences and readmissions of TC and cardiovascular mortality.</p> <p><strong>Results:</strong> 148 patients were included, 90% women, mean age 66±12 years. In-hospital mortality was 2% and overall mortality in follow up (55±33 months) was 2.4%. TC recurrence in follow-up was 4.0%.</p> <p>The TC triggered by emotional stress, in contrast to a physical trigger, was more prevalent in female gender (98% vs 70%, p<0.001) and is associated with hypertension (72% vs 43%, p=0.001) and chest pain at admission (95% vs 68%, p<0.001). On the contrary, physical trigger are associated with dyslipidemia (43% vs 64%, p=0.023) and dyspnea (15% vs 34%, p=0.01). Regarding electrocardiographic parameters, there were no differences between groups.</p> <p>During admission, the incidence of new onset acute heart failure in patients with physical trigger was higher (4.8% vs 16%, p=0.024). Also these patients have a worse global systolic function (12% vs 27%, p=0.04) and a higher need of inotropic therapy and non-invasive mechanical ventilation (1.0% vs 6.8%, p=0.04). In-hospital mortality was also higher in the patients with physical trigger identified (0% vs 4.5%, p=0.03).</p> <p>After discharge, the complication such as death (1.2% vs 7.4%, p=0.05) and recurrences of TK (3.7% vs 7.9%, p=0.03) were more observed in G2 group.</p> <p><strong>Conclusions:</strong> According to this study, in TC patients in which a physical trigger was identified, could present short and long term prognosis in terms of occurrence of new onset acute heart failure, cardiovascular mortality, recurrences and hospital readmissions. </p>
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