Takotsubo cardiomyopathy: An Australian single centre experience with medium term follow-up

Samardhi, H.; Raffel, O.; Sirisena, T.; Walters, D.

doi:10.1016/j.hlc.2009.05.626

Cited by 6 publications

(8 citation statements)

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“…Seven studies on the effects of β‐blockers on the prevention of TTC recurrence were evaluated in a pooled analysis . In aggregate, the pooled studies included 471 subjects.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies on the effects of angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on prevention of TTC recurrence were evaluated in a pooled analysis . In aggregate, the pooled studies included 275 subjects.…”

Section: Resultsmentioning

confidence: 99%

“…The remaining 165 records were screened, and 140 of them were excluded because the median follow‐up was shorter than 3 months. Twenty‐five full‐text articles were assessed for eligibility, but only 8 studies met all the inclusion criteria (Table ) …”

Section: Methodsmentioning

confidence: 99%

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Lack of Efficacy of Drug Therapy in Preventing Takotsubo Cardiomyopathy Recurrence: A Meta‐analysis

Santoro

Ieva

Musaico

et al. 2014

Clinical Cardiology

124

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Background: Efficacy of chronic drug therapy in prevention of stress-induced cardiomyopathy recurrences is not well established. We therefore aimed to evaluate in this meta-analysis whether pharmacological treatment can effectively prevent takotsubo cardiomyopathy (TTC) recurrences, according to available studies. Hypothesis: There is no evidence for preventing TTC recurrence by drug therapy. Methods: After a PubMed search, we conducted a meta-analysis of available studies (clinical nonrandomized registries) on efficacy of drug therapy in preventing recurrence of TTC. Results: A total of 23 (4.5%) TTC recurrences occurred in the 511 patients included in the analysis. Seven studies on the effects of β-blockers on prevention of TTC recurrence were evaluated; the odds ratio (OR) was 0.44 and the 95% confidence interval (CI) was 0.15-1.31. In 5 studies on the effects of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, the OR was 0.42 and the 95% CI was 0.08-2.36; in 3 studies on statins, the OR was 0.74 and the 95% CI was 0.07-7.3; and in 4 studies on aspirin, the OR was 0.33 with a 95% CI of 0.05-2.17 (P value not significant in all cases). Conclusions: A meta-analysis of the efficacy of different medications through the clinical TTC registries available showed no clinical evidence for a standard drug treatment in the chronic management of TTC. β-Blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, statins, and aspirin do not seem to significantly reduce recurrences of TTC. Randomized, adequately powered studies are needed to further assess this issue. IntroductionTakotsubo cardiomyopathy (TTC) is a rapidly reversible form of acute heart failure occurring mainly in postmenopausal women after an episode of physical or emotional stress 1 and is associated with a typical left ventricular (LV) contraction pattern. 2 Increased catecholamine levels were thought to be the primary precipitator of the condition, 3 but the exact mechanism is still not well elucidated. 4,5 The initial treatment for TTC is usually the same as adopted for acute heart failure, except for contraindication to β-adrenergic inotropes 6 ; data on the efficacy of chronic pharmacological therapy, however, are scanty. Despite its relatively good long-term prognosis, 7 recurrences of TTC are not infrequent, with a rate ranging from 5% to 11.4% within the first 4 years and an incidence per year of 2.4%. 8,9 β-Blockers are commonly used chronically to prevent TTC recurrence, but, given the rarity of TTC, there are no randomized studies supporting this approach.We therefore conducted a meta-analysis of currently available studies to evaluate whether drug therapy can effectively prevent TTC recurrences.

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“…Seven studies on the effects of β‐blockers on the prevention of TTC recurrence were evaluated in a pooled analysis . In aggregate, the pooled studies included 471 subjects.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Lack of Efficacy of Drug Therapy in Preventing Takotsubo Cardiomyopathy Recurrence: A Meta‐analysis

Santoro

Ieva

Musaico

et al. 2014

Clinical Cardiology

124

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“…Although the most common trigger is known to be emotional stress, 2) intracranial disease, in particular subarachnoid hemorrhage, is also known to cause takotsubo cardiomyopathy. However, the Mayo Criteria requires the absence of recent significant head trauma and intracranial bleeding for the diagnosis of takotsubo cardiomyopathy, 5) and the guidelines for diagnosis of takotsubo cardiomyopathy in Japan suggest that takotsubo cardiomyopathy with cerebrovascular disease should instead be named cerebrovascular disease with takotsubo-like myocardial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Infarction Arising from Takotsubo Cardiomyopathy: Case Report and Literature Review

Otani

Tokunaga²,

Kawauchi³

et al. 2016

NMC Case Report Journal

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Although most patients with takotsubo cardiomyopathy have a favorable outcome, complications are not uncommon. Recent studies have reported an increase in incidence of cardioembolic complications; however, the association between takotsubo cardiomyopathy and stroke, in particular thromboembolic cerebral infarction, remains unclear. We reported a 44-year-old woman who had a cerebral infarction resulting from takotsubo cardiomyopathy. She had felt chest discomfort a few days prior to infarction, and later developed left hemiparesis. Head magnetic resonance imaging (MRI) revealed acute infarction in the right insular cortex and occlusion of the right middle cerebral artery at the M2 segment. Echocardiogram revealed a takotsubo-like shape in the motion of the left ventricular wall, and coronary angiography showed neither coronary stenosis nor occlusion. Cerebral infarction resulting from takotsubo cardiomyopathy was diagnosed and treatment with anticoagulant was started. MRI on the eighth day after hospitalization showed recanalization of the right middle cerebral artery and no new ischemic lesions. The findings of the 19 previously published cases who had cerebral infarction resulting from takotsubo cardiomyopathy were also reviewed and showed the median interval between takotsubo cardiomyopathy and cerebral infarction was approximately 1 week and cardiac thrombus was detected in 9 of 19 patients. We revealed that thromboembolic events occurred later than other complications of takotsubo cardiomyopathy and longer observation might be required due to possible cardiogenic cerebral infarction. Anticoagulant therapy is recommended for patients with takotsubo cardiomyopathy with cardiac thrombus or a large area of akinetic left ventricle.

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“…Istnieje udokumentowany przypadek pacjentki, u której choroba wystąpiła 4-krotnie [7]. W więk-szości przypadków rokowanie jest korzystne, u niektórych chorych jednak dochodzi do groźnych powikłań, które mogą być nawet przyczyną zgonu [8][9][10][11][12][13][14].…”

Section: Wstępunclassified

Parametry echokardiograficzne wpływające na rokowanie pacjentów z kardiomiopatią takotsubo

Budnik

2017

Folia Cardiologica

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StreszczenieKardiomiopatia takotsubo to odwracalna dysfunkcja skurczowa lewej komory, której objawy przypominają ostry zespół wieńcowy. Rokowanie jest na ogół korzystne -w ciągu kilku tygodni dochodzi do poprawy funkcji skurczowej lewej komory, jednak czasami występują powikłania, takie jak ostra niedomykalność mitralna, dysfunkcja prawej komory, zawężanie drogi odpływu lewej komory, skrzeplina w lewej komorze, ostra niewydolność serca lub wstrząs kardiogenny, które mogą nawet prowadzić do zgonu. Dlatego niezwykle istotne jest znalezienie czynników, które wpływają na rokowanie pacjentów, a które są łatwo i szybko dostępne.Słowa kluczowe: takotsubo, zespół balotującego koniuszka, kardiomiopatia stresowa Cardiologica 2016; 11, 6: 569-574 Folia

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Takotsubo cardiomyopathy: An Australian single centre experience with medium term follow-up

Cited by 6 publications

References 0 publications

Lack of Efficacy of Drug Therapy in Preventing Takotsubo Cardiomyopathy Recurrence: A Meta‐analysis

Lack of Efficacy of Drug Therapy in Preventing Takotsubo Cardiomyopathy Recurrence: A Meta‐analysis

Cerebral Infarction Arising from Takotsubo Cardiomyopathy: Case Report and Literature Review

Parametry echokardiograficzne wpływające na rokowanie pacjentów z kardiomiopatią takotsubo

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