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Publish Date : 2016-05-12
Journal of Heart and Cardiology

Factors Suggestive of Cardiac Complications in Takotsubo Cardiomyopathy: Multicenter Study

Mitsuaki Isobe
Tomoko Manno1,2, Kenichiro Otomo1, Takashi Shibui3, Hiroyuki Fujii4, Toru Obayashi5, Yasuhiro Sato6, Osamu Yanase7, Mitsuaki Isobe2*
Article information 

Affiliation

  • 1Department of Cardiovascular Medicine, Ome Municipal General Hospital
  • 2Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • 3Department of Cardiology, Toshima Hospital
  • 4Department of Cardiology, Yokohama Minami Kyousai Hospital
  • 5Department of Cardiology, Japan Red Cross Musashino Hospital
  • 6Department of Cardiology, NHO Disaster Medical Center
  • 7Department of Cardiology, Tokyo Metropolitan Otsuka Hospital

Corresponding Author

Mitsuaki Isobe, M.D., PhD, Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyoku, Tokyo-113-8519, Japan, Tel: 81-3-5803-5951; Fax: 81-3-5803-0238; E-mail: isobemi.cvm@tmd.ac.jp

Citation

Isobe, M., et al. Factors Suggestive of Cardiac Complications in Takotsubo Cardiomyopathy: Multicenter Study. (2016) J Heart Cardiol 2(1): 33-38.

Copy rights

© 2016 Isobe, M. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.

Keywords

Abstract

 

Background: Takotsubo cardiomyopathy (TM) is characterized by acute and transient myocardial segmental wall motion abnormality especially at the apical area with chest pain mimicking acute myocardial infarction. TM is generally accepted to show good prognosis, however, we experience some cases with severe cardiac complications including acute heart failure (AHF), cardiac rupture and ventricular arrhythmias. We characterized TM patients developing these complications.
Methods and results: Eighty three patients were studied. Patients with AHF, cardiac rupture, ventricular arrhythmias and death due to cardiac complications (CC group, n = 29) were compared with other patients without cardiac complications (NC group, n = 54). There was no difference between the two groups in age, sex, and coronary risk factors. Common primary symptom in the CC group was dyspnea but was chest pain in NC group. A preceding emotional stress was a common trigger for CC group. Left ventriculography showed significantly decreased ejection fraction in the CC group (39.7 ± 10.2% vs. 53.9 ± 14.1%, p = 0.002). Similarly, more than two segments of impaired left ventricular wall motion was a significant predictor of severe cardiac complications.
Conclusions: Clinical onset with dyspnea and extended area of left ventricular ballooning are signs predicting cardiac complications in TM.