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Comparison of electrographic changes, clinical features and outcomes in different variants of Takotsubo syndrome

International journal of cardiology, 2024-07, Vol.406, p.132072 [Peer Reviewed Journal]

Copyright © 2024 Elsevier B.V. All rights reserved. ;EISSN: 1874-1754 ;DOI: 10.1016/j.ijcard.2024.132072 ;PMID: 38643795

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  • Title:
    Comparison of electrographic changes, clinical features and outcomes in different variants of Takotsubo syndrome
  • Author: Looi, Jen-Li ; Voss, Jamie ; Gilmore, Jill ; Heaven, David ; Lee, Mildred ; Kerr, Andrew J
  • Subjects: Aged ; Aged, 80 and over ; Echocardiography - methods ; Electrocardiography - methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Takotsubo Cardiomyopathy - diagnosis ; Takotsubo Cardiomyopathy - diagnostic imaging ; Takotsubo Cardiomyopathy - physiopathology
  • Is Part Of: International journal of cardiology, 2024-07, Vol.406, p.132072
  • Description: Dysfunction of the left ventricular (LV) apex (apical variant) is the most common form in Takotsubo syndrome (TS). Several less common non-apical variants have been described - mid-ventricular, basal and focal. We hypothesised that the clinical presentation, and electrocardiographic (ECG) findings may vary between apical and non-apical TS. We prospectively identified 194 consecutive patients with TS presenting to Middlemore Hospital, Auckland and obtained clinical, echocardiography, coronary angiography, and long-term follow-up data. ECGs at admission and Day 1 were compared. Of 194 patients with TS, 168 (86.6%) had apical TS, and 26 (13.4%) non-apical TS (11 mid-ventricular TS, 5 basal TS, 10 focal TS). Apical TS patients had more significant LV systolic impairment (p = 0.001) and longer length of stay (p = 0.001). The extent of T-wave inversion (TWI) was similar for both groups on admission (p = 0.88). By Day 1 the extent of TWI was greater in apical TS group (median number of leads 5 vs. 1, p = 0.02). The change in QTc interval between admission and Day 1 was greater in apical TS group (29.7 ms vs. 2.77 ms, p < 0.001). Composite in-hospital complication rate was similar for both groups (13.7% vs. 15.4%, p = 0.77). Compared with non-apical variants, apical TS patients develop more extensive TWI and greater QT prolongation on ECG, and more significant LV systolic impairment, but in-hospital complications were similar. Clinicians should be aware that there is a sub-group of TS patients who have non-apical regional wall motion abnormalities and who don't develop ECG changes typical of the more common apical variant.
  • Publisher: Netherlands
  • Language: English
  • Identifier: EISSN: 1874-1754
    DOI: 10.1016/j.ijcard.2024.132072
    PMID: 38643795
  • Source: MEDLINE
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