Takotsubo Cardiomyopathy and Non-ST-Segment Elevation Myocardial Infarction: Predictors of Left Ventricular Dysfunction

Abstract

Background: Acute coronary syndrome (ACS) from non-ST-segment elevation myocardial infarction (NSTEMI) and Takotsubo (TK) cardiomyopathy present with similar initial clinical features and can result in left ventricular (LV) dysfunction and acute heart failure. Methods: This study was a retrospective case-control study that identified patients aged 18 years and older who presented with ACS and underwent cardiac catheterization. Results: There were a total of 321 patients in the TK group and 1031 patients in the NSTEMI group. There was significantly worse LV dysfunction in the TK group with average ejection fraction (EF) of 44.35% (±15.11%) versus NSTEMI with an average EF of 47.36% (±13.5%) ( P < .001). The presence of TK yielded of an odds ratio (OR) of 2.373 (95% confidence interval [CI]: 1.165-3.618) and presence of peripheral artery disease (PAD) yielded an OR of 2.053 (95% CI: 1.165-3.618). Conclusions: The presence of TK cardiomyopathy and PAD were independent predictors of patients who had LVEF of <35% and elevated B-type natriuretic peptide levels.

Perspectives on Resolving Diagnostic Challenges between Myocardial Infarction and Takotsubo Cardiomyopathy Leveraging Artificial Intelligence

“…Acute myocardial infarction (MI) and takotsubo cardiomyopathy (TTC) are two cardiovascular emergencies that exhibit striking clinical similarities in their presentations. Distinguishing between the two conditions in the emergency room can be extremely challenging, especially given the limited time available for prompt diagnosis and treatment [9,12]. Figure 2 illustrates the clinical similarities and distinctions between acute myocardial infarction and takotsubo cardiomyopathy.…”

“…Acute detection of takotsubo cardiomyopathy (TTC) is crucial due to differences in care. However, it is challenging given the similarity in clinical presentation, ECG, and cardiac biomarkers characteristics with myocardial infarction [9]. Currently, emergency coronary angiography and ventriculography are eventually needed to confirm the diagnosis [10].…”