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Nobuyuki Kagiyama, Hiroyuki Okura, Tomoko Tamada, Koichiro Imai, Ryotaro Yamada, Teruyoshi Kume, Akihiro Hayashida, Yoji Neishi, Takahiro Kawamoto, Kiyoshi Yoshida, Impact of right ventricular involvement on the prognosis of takotsubo cardiomyopathy, European Heart Journal - Cardiovascular Imaging, Volume 17, Issue 2, February 2016, Pages 210–216, https://doi.org/10.1093/ehjci/jev145
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Abstract
Previous studies showed that patients with takotsubo cardiomyopathy had a higher long-term mortality rate than the general population and the incidence of in-hospital complications was higher in takotsubo cardiomyopathy with than without right ventricular (RV) involvement. This study was performed to investigate the long-term prognostic impact of RV involvement in takotsubo cardiomyopathy.
The clinical data of 113 patients (72.7 ± 11.4 years old, 84 females) with takotsubo cardiomyopathy were studied retrospectively. The patients were divided into two groups according to the presence (biventricular group, n = 21, 18.6%) or absence (classical group, n = 92, 81.4%) of RV involvement assessed by initial echocardiography. The end point was a composite of all-cause death, re-hospitalization due to heart failure, and recurrence of takotsubo cardiomyopathy. The in-hospital mortality rate was significantly higher in the biventricular group than the classical group (14.3 vs. 1.1%, respectively, P = 0.02). Kaplan–Meier analysis indicated a significantly lower event-free survival rate in the biventricular group than the classical group (log-rank, P < 0.001). On multivariate analysis, RV involvement was the only independent predictor of the end point (HR: 2.73, P = 0.026).
The rates of in-hospital and long-term events were significantly higher in takotsubo cardiomyopathy with than without RV involvement, and RV involvement was the independent predictor of the poor prognosis.
