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Predictors of in-hospital left ventricle function recovery in Takotsubo Syndrome
Session:
Posters (Sessão 5 - Écran 3) - Doenças do Miocárdio e Pericárdio 2
Speaker:
Geraldo Faia Carvalho Dias
Congress:
CPC 2022
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.2 Myocardial Disease – Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Geraldo Dias; Ana Filipa Cardoso; Tamara Pereira; Mariana Tinoco; Filipa Almeida; António Lourenço
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Background: Left ventricular (LV) disfunction in Takotsubo Syndrome (TS) is usually temporary, and a full recovery is expected over time. Nevertheless, some patients are discharged from the hospital without a full recovery of LV systolic function. In this study, we sought to evaluate the in-hospital LV systolic function recovery, and investigate its clinical predictors.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods: We performed a retrospective study including patients diagnosed with TS in a single center from January 2018 to December 2020. Clinical, electrocardiographic, laboratory, and echocardiographic data were analyzed. Full recovery was considered when a preserved LV systolic function was documented within the time of hospital stay.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results: A total of 38 patients were included, of whom 29 (76.3%) were female. The median age was 68.5 (IQR=17.0) years. Twenty-two patients (57.9%) had full LV systolic function recovery before discharge, while 14 (36.8%) presented mild LV dysfunction and 2 (5.3%) moderate LV dysfunction.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">When comparing the 22 patients that experienced full recovery with the remaining 16, there were no significant differences considering age (71 IQR=21 vs 68.5 IQR=17 years, respectively), gender distribution (77.3% vs 75.0% females), prevalence of cardiovascular risk factors, atrial fibrillation or psychiatric disorders. Hospital stay median duration was comparable in both groups (6, IQR=5 vs 6.5, IQR=5 days). Similarly, no difference was found in laboratory values of troponin I, B type natriuretic peptide or C reactive protein.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">More patients in the residual dysfunction group presented an identifiable trigger (81.2% vs 21.1%; p= 0.006) and newly developed conduction abnormalities (25.0% vs 0.0%, p=0.025). On the other hand, more patients in the group that experienced full recovery presented with severe dysfunction at admission (63.8% vs 18.8%, p=0.006), syncope (31.8% vs 0.0%, p=0.014) and T wave inversion in V5-V6 (100.0% vs 71.4%, p= 0.017). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion: Our data sugests that a greater LV systolic dysfunction at presentation might predict a more complete recovery of LV function during hospital stay, and that gender differences aren’t present between the groups. This is in contrast to some studies that report LV dysfunction and the male gender as negative factors for early recovery. Additionally, in this study, the presence of a trigger and newly developed conduction abnormalities were negatively associated to LV recovery.</span></span></p>
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