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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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Takotsubo cardiomyopathy: Chronobiological variation
Session:
Posters 1 - Écran 4 - Doenças do Miocárdio
Speaker:
Pedro von Hafe Leite
Congress:
CPC 2019
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.2 Myocardial Disease – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Pedro Von Hafe Leite; Bebiana Faria; Geraldo Dias; Ana Filipa Cardoso; Dina Bento; Nuno Marques; Sílvia Ribeiro; Olga Azevedo; António Lourenço
Abstract
<p><strong>Background</strong>: Takotsubo cardiomyopathy (TTC) is a stress-induced syndrome, characterized by transient systolic dysfunction due to akinesia of the left-ventricular (LV) mid-apical segments.</p> <p>There have been few data to review and analyze the temporal preference of the onset of TTC in detail.</p> <p><strong>Purpose</strong>: Aim of this study was to investigate chronobiological variations in the occurrence of TTC.</p> <p><strong>Methods</strong>: Multicentric, retrospective study with a sample of 101 patients diagnosed with TTC from January 2004 to December 2017. These patients were grouped according to the time of day, day of the week, month and season in which the symptoms appeared. Subanalyses were performed for gender, age and precipitating factor.</p> <p><strong>Results</strong>: In this study, TTC patients were predominantly female (92%, n = 93) and had a mean age of 76 ± 12 years. Precipitating factor was present in 56 patients (55.4%).</p> <p>The onset of TTC had the peak in summer (n = 46, 45,5%) and the nadir in winter (n = 9, 8.9%, p < 0001). Events were most frequent in August and June (n = 16, 15.8 p < 0.001).TTC was most frequent in the morning (n = 22, 34.4%) compared to night (n = 6, 9.4%, p = 0.018), and most frequent on Wednesday (n = 21, 20.8%) and least on Friday (n= 6, 5.9%, P = 0.041).</p> <p>In men, there were no differences in temporal distribution. Women had more events in summer (n = 43, 46.2%, p < 0,001), in June (n = 16, 17.2%, p < 0,001), on Wednesday (n = 20, 21.5%, p = 0.016). There wasn’t a statistically significant difference in circadian rhythm. Patients were split by age (±75 years). In older patients, season and time of day showed a statistically difference, with more events in summer (n = 26, 46.4%, p = 0.001) and morning (n = 14, 25%, p = 0.016). In younger patients just season had a statistically difference, with more frequency in summer (n = 22, p = 0.001).</p> <p>Patients presenting with documented stress event had more events on Thursday and at evening (n = 16, 28.6%, p = 0.017 and n = 15, 28.8%, p = 0.040).</p> <p><strong>Conclusion</strong>: TTC seems to exhibit a temporal variation of occurrence with preferred peaks during morning, Wednesday and summer. Age, gender and stressor pattern do not influence these temporal patterns of the occurrence of TTC, except in patients with precipitating factor that demonstrate a higher frequency of events on Thursday and at evening. Further studies are needed to investigate the potential link between chronobiological variations of TTC onset and underlying pathophysiologic mechanisms.</p>
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