Prognostic factors of Takotsubo cardiomyopathy: a systematic review

Abstract

Takotsubo cardiomyopathy (TCM), characterized by reversible ventricular dysfunction, has similar mortality to acute coronary syndrome. With the growing interest in the diagnosis of and interventions for TCM, many risk factors had been found to affect the prognosis of TCM patients, such as age, sex, and pre-existing diseases. Because of the incomplete understanding of the pathophysiologic mechanism in TCM, evidence-based medical therapy for this condition is lacking. Early intervention on risk factors may improve the outcomes of TCM. In this review, we sought to provide up-to-date evidence on risk factors and medical therapies that affect TCM outcome. We found that male sex, physical triggers, and certain comorbidities such as chronic kidney disease, malignant disease, higher body mass index, sepsis, chronic obstructive pulmonary disease, and anaemia were associated with poor TCM prognosis. In contrast, race, hyperlipidaemia, diabetes mellitus, and mood disorders were not clearly associated with TCM prognosis. We also reviewed the effect of medical therapies on TCM outcome, including angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β-blockers, calcium channel blockers, and statins. The evidence that these medications confer a survival benefit on TCM patients is limited. Understanding these prognostic factors could help develop risk-stratification tools for TCM and establish effective prevention and interventions for this notso-benign condition. Further multicentre clinical studies with large samples and meta-analyses of findings from previous studies are needed to address the inconsistent findings among the many potential risk factors for TCM.

Development and validation of a prognostic nomogram for Takotsubo syndrome patients in the intensive care units: a retrospective cohort study

“…Patients with lower hematocrit levels tend to be anemia. Some evidence supported the relationship of anemia with poor outcomes of TTS 31,32 . Some analyses applied hematocrit to predict in-hospital death in patients with heart failure.…”

Reverse Takotsubo cardiomyopathy after orthotopic liver transplantation. A case report

“…Pelliccia et al reported that cardiovascular comorbidities could predispose to stress cardiomyopathy, with the most important being dyslipidemia, obesity, and hypertension [ 16 ]. Another recent article revealed that male gender is associated with worse outcomes [ 17 ]. No other specific risk factors, like chronic heart failure or valvulopathies, were identified [ 17 ].…”

“…Another recent article revealed that male gender is associated with worse outcomes [ 17 ]. No other specific risk factors, like chronic heart failure or valvulopathies, were identified [ 17 ].…”

Takotsubo cardiomyopathy. Literature review: clinical performance, diagnostic algorithm, treatment, prognosis. Part II

“…Что касается иАПФ/БРА, ББ, то в настоящее время данные по эффективности этих препаратов в отдаленном периоде заболевания у больных с КТ довольно противоречивы [40,53]. В одном из крупнейших регистров пациентов с КТ продемонстрировали, что использование иАПФ/БРА связано с улучшением выживаемости через 1 год, однако не было получено никаких доказательств улучшения выживаемости при использовании ББ [1].…”