Tako-tsubo Cardiomyopathy Complicated by QRS Prolongation

Kurisu, Satoshi; Ishibashi, Ken; Kato, Yasuko; Matsumoto, Naoya; Dohi, Yoshihiro; Nishioka, Kenji; Kihara, Yasuki

doi:10.2169/internalmedicine.51.6292

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…Only one case report noted transient pQRSd in TC. 22 In that report, the patient had pulmonary edema and pQRSd on admission, but the QRS duration was normalized immediately after the introduction of IABP. This may indicate that pQRSd in TC reflects myocardial ischemia due to microvascular dysfunction, because IABP improves coronary driving pressure.…”

Section: Clinical Outcomesmentioning

confidence: 89%

Predictive Value of QRS Duration at Admission for In-Hospital Clinical Outcome of Takotsubo Cardiomyopathy

Yamaguchi

Yoshikawa²,

Isogai³

et al. 2017

Circ J

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ing, multicenter, population-based cohort database of emergency admissions to acute cardiac care facilities in Tokyo. It was launched in 1978 and expanded to 71 largevolume cardiovascular facilities. We launched the TC research group in 2010 and started collecting data on patients with TC admitted to facilities participating in the Tokyo CCU Network. Data on TC patients were collected retrospectively, and included original copies of ECG for a 3-year period between 2010 and 2012. Data have been collected prospectively since 2013, but do not include original copies of ECG. Therefore, we used data collected between 2010 and 2012 for this study. The requirement for informed consent was waived because all data were anonymously catalogued. As stated in a preceding article from a Tokyo CCU Network registered cohort, 11 patient data collection policies are displayed at the emergency entrance of each facility in accordance with rules set forth by the Ministry of Internal Affairs and Communications. The aim of the registry and personal information protection policy T akotsubo cardiomyopathy (TC) is characterized by reversible left ventricular (LV) dysfunction not caused by coronary artery disease (CAD). 1-3 The in-hospital mortality rate is between 0% and 8%, 2-5 and the rate of major adverse cardiac and cerebrovascular events is 7.1%. 5 J wave and QT prolongation on electrocardiogram (ECG) are predictors of short-term outcome in TC, 6,7 but the prognostic impact of prolonged QRS duration (pQRSd) in TC remains unknown, although it is a strong predictor of poor outcome in previous myocardial infarction, congestive heart failure (HF), and myocarditis. 8- 10 The aim of the present study was to examine the predictive value of pQRSd for in-hospital clinical outcomes of TC, using a multicenter database in Japan. Methods SubjectsThe Tokyo CCU Network database is a prospective, ongo- Background: Prolonged QRS duration (pQRSd) on electrocardiogram (ECG) is a strong predictor of poor outcome in heart failure, myocardial infarction, and myocarditis, but it is unclear whether pQRSd also predicts poor outcomes of takotsubo cardiomyopathy (TC).

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Section: Clinical Outcomesmentioning

confidence: 89%

Predictive Value of QRS Duration at Admission for In-Hospital Clinical Outcome of Takotsubo Cardiomyopathy

Yamaguchi

Yoshikawa²,

Isogai³

et al. 2017

Circ J

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“…Regarding the therapy strategies, in addition to conventional anti-infection therapy and the control of inducing factors, blood sugar and blood pressure, the important treatment measures for this patient involved haemodynamic correction, antiplatelet therapy and anticoagulation. IABP increases the coronary perfusion pressure by increasing the diastolic pressure in the aorta, which reduces coronary vascular dysfunction and decreases the left ventricular systolic internal aortic pressure to increase the cardiac output, thereby reducing the left ventricular end-diastolic pressure and myocardial oxygen consumption [ 18 ]. This emergency measure that was given to improve the haemodynamic function of the ventricle improved the pump failure caused by acute myocardial infarction or TTS.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of a severe Takotsubo syndrome case complicated by liver abscess

Zhang

Sun

Wang

et al. 2023

BMC Cardiovasc Disord

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The main manifestations of Takotsubo syndrome (TTS) are a spherical expansion of the left ventricle or near the apex and decreased systolic function. TTS is mostly thought to be induced by emotional stress, and the induction of TTS by severe infection is not often reported. A 72-year-old female patient with liver abscess reported herein was admitted due to repeated fever with a history of hypertension and impaired glucose tolerance. Her severe infection caused TTS, and her blood pressure dropped to 80/40 mmHg. IABP treatment was performed immediately and continued for 10 days, and comprehensive medication was administered. Based on her disease course and her smooth recovery, general insights and learnings may be: Adding to mental and other pathological stress reaction, serious infections from pathogenic microorganism could be of great important causation of stress reaction leading to TTS, while basic diseases such as coronary heart disease, hypertension, and diabetes were be of promoting factors; In addition to effective drug therapies for TTS, the importance of the timely using of IABP should be emphasized.

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“…As for treatment, although optimal management has not been established, it is desirable to avoid or taper catecholamine use if possible and to treat heart failure with diuretics, hAMP, vasodilators, and β-blockers to reduce the pre- and after-load. In a serious case, use of intra-aortic balloon pumping (IABP) can also be considered until the cardiac function improves, and a dynamic blood circulation state should be managed strictly [ 13 ]. If the cardiac function is maintained successfully with conservative management, cardiac function will return to a normal level without specific treatment and the prognosis is good in most cases.…”

Section: Discussionmentioning

confidence: 99%

A rare case of transient left ventricular apical ballooning syndrome following living donor liver transplantation: A case report and literature review

Tanaka

Onoe

Ishiyama

et al. 2019

International Journal of Surgery Case Reports

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Highlights Transient Left Ventricular Apical Balloon Syndrome (LV-ABS) is an acute dysfunction of the left ventricle. Its clinical feature is similar to myocardial infarction. The echocardiogram show characteristic finding which is different from that of myocardial infarction. LV-ABS is rare, however, should be considered after liver transplantation. Proper diagnosis is important to restore cardiac function although it improve almost normally with conservative treatment.

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Tako-tsubo Cardiomyopathy Complicated by QRS Prolongation

Cited by 5 publications

References 10 publications

Predictive Value of QRS Duration at Admission for In-Hospital Clinical Outcome of Takotsubo Cardiomyopathy

Predictive Value of QRS Duration at Admission for In-Hospital Clinical Outcome of Takotsubo Cardiomyopathy

Successful treatment of a severe Takotsubo syndrome case complicated by liver abscess

A rare case of transient left ventricular apical ballooning syndrome following living donor liver transplantation: A case report and literature review

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