Left Ventricular Apical Ballooning Due to Severe Physical Stress in Patients Admitted to the Medical ICU

Park, Jae‐Hyeong; Kang, Soo–Jin; Song, Jae‐Kwan; Kim, Hyun Kuk; Lim, Chae Man; Kang, Duk–Hyun; Koh, Younsuck

doi:10.1378/chest.128.1.296

Cited by 279 publications

(197 citation statements)

References 28 publications

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“…It was characterized by akinesia/hypokinesia of the mid-to-distal portion of the left ventricular chamber, with normokinesia/hyperkinesia of the basal portion with an ejection fraction of <50% on transthoracic echocardiography. 7 Patients with idiopathic cardiomyopathy, pheochromocytoma, or prior myocardial infarction were excluded from this study.…”

Section: Study Populationmentioning

confidence: 99%

Presentation of Tako‐tsubo Cardiomyopathy in Men and Women

Kurisu¹,

Inoue²,

Kawagoe³

et al. 2010

Clinical Cardiology

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Background: Recent studies have demonstrated that stress-induced Tako-tsubo cardiomyopathy is likely to occur in elderly female patients. Objectives: The purpose of this study was to evaluate gender differences in the clinical characteristics of patients with Tako-tsubo cardiomyopathy. Methods: This study consisted of 102 patients with Tako-tsubo cardiomyopathy. It was characterized by akinesia/hypokinesia of the mid-to-distal portion of the left ventricular chamber, with normokinesia/hyperkinesia of the basal portion with an ejection fraction of less than 50% on transthoracic echocardiography. Results: There were 13 male and 89 female patients. In 10 male patients (77%), Tako-tsubo cardiomyopathy occurred during or immediately after receiving medical treatment or examination for an underlying disease. In 9 male patients (69%), objective symptoms such as abnormality of monitoring or low blood pressure, but not subjective symptoms increased the chance of the patient being diagnosed with Tako-tsubo cardiomyopathy. There was no significant difference in age, body weight, hypertension, or diabetes except for height between male and female patients. The incidence of in-hospital onset was significantly higher in male patients than in female patients (77% vs 17%, P < 0.01). There was no significant difference in in-hospital mortality (15% vs 6%, P = not significant). Conclusions: These results suggested that physical stress might have more to do with the occurrence of Tako-tsubo in male than female patients.

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Section: Study Populationmentioning

confidence: 99%

Presentation of Tako‐tsubo Cardiomyopathy in Men and Women

Kurisu¹,

Inoue²,

Kawagoe³

et al. 2010

Clinical Cardiology

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“…The authors concluded that STA ''could be used for sensitive detection of stress cardiomyopathy'' and that ''this is critical because cardiac impairment remains a major cause of morbidity and mortality after SAH'' [1]. This study reminds me of the work of Korean investigators who prospectively carried out serial TTE in patients admitted to the medical intensive care unit and detected TTS in 21 % [6], and 28 % [7], of patients with critical illness. Accordingly, although the frequency of TTS, associated with depressed LVEF, in patients with SAH when diagnosed by routine clinical evaluation in retrospective studies has been described to be approximately 1 % [8], it will be found to be much higher in prospective studies employing serial TTE.…”

mentioning

confidence: 78%

Speckle tracking in patients with atypical Takotsubo syndrome: seek, and ye shall find!

Madias

2015

Intensive Care Med

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“…Second, the initial TTC criteria were proposed in 2004 with a subsequent revision in 2008 that potentially resulted in the further unification of clinical definitions and higher awareness in treating physicians 2, 5. The first reported series of TTC in sepsis was in 2005, providing additional awareness 30. Third, there has been a growing interest in cardiovascular outcomes in sepsis in recent years, potentially influencing clinical diagnostic and management pathways 9, 11, 12.…”

Section: Discussionmentioning

confidence: 99%

Tako‐Tsubo Cardiomyopathy in Severe Sepsis: Nationwide Trends, Predictors, and Outcomes

Vallabhajosyula

Deshmukh

Kashani

et al. 2018

JAHA

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BackgroundThere are limited data on the presentation of Takotsubo cardiomyopathy (TTC) in severe sepsis.Methods and ResultsThis was a retrospective cohort study using the National Inpatient Sample database (2007–2013) of all adults with severe sepsis. TTC was identified in patients with severe sepsis using previously validated administrative codes. The primary outcome was in‐hospital mortality, and secondary outcomes included resource utilization and discharge disposition. Regression analysis was performed for the entire cohort and a propensity‐matched sample. An exploratory analysis was performed for predictors of TTC incidence and mortality in TTC. During this 7‐year period, in 7.1‐million hospitalizations for severe sepsis, TTC was diagnosed in 10 746 (0.15%) admissions. TTC was noted more commonly in whites, females, and among 65‐ to 79‐year‐old individuals. TTC was independently associated with lower in‐hospital mortality in severe sepsis (odds ratio, 0.58; 95% confidence interval, 0.51–0.65). This association was more prominent in females (odds ratio, 0.51; 95% confidence interval, 0.44–0.59]) compared with males (odds ratio, 0.69; 95% confidence interval, 0.55–0.85]). Presentation in later years of the study period, middle‐age, female sex, and white race were independent predictors for the diagnosis of TTC. Age ≥80 years, black race, greater comorbidity, and multiorgan dysfunction were independently associated with higher in‐hospital mortality among TTC admissions.Conclusions TTC is observed with increasing frequency in severe sepsis and was associated with a significantly lower in‐hospital mortality compared with patients without TTC. Presentation in later years of the study period, middle age, female sex, and white race were independent predictors for the diagnosis of TTC in severe sepsis.

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Left Ventricular Apical Ballooning Due to Severe Physical Stress in Patients Admitted to the Medical ICU

Cited by 279 publications

References 28 publications

Presentation of Tako‐tsubo Cardiomyopathy in Men and Women

Presentation of Tako‐tsubo Cardiomyopathy in Men and Women

Speckle tracking in patients with atypical Takotsubo syndrome: seek, and ye shall find!

Tako‐Tsubo Cardiomyopathy in Severe Sepsis: Nationwide Trends, Predictors, and Outcomes

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