Journal article
"Takotsubo effect" in patients with ST segment elevation myocardial infarction
European heart journal. Acute cardiovascular care, Vol.9(7), pp.711-720
10/2020
DOI: 10.1177/2048872620926680
PMID: 32508142
Abstract
Myocardial infarction can be a trigger of Takotsubo syndrome. We recently characterized imaging features of acute myocardial infarction-induced Takotsubo syndrome ("Takotsubo effect"). In this study, we investigate diagnostic and prognostic implications of Takotsubo effect in patients with anterior wall ST-segment elevation myocardial infarction.
We enrolled 111 consecutive patients who developed anterior wall ST-segment elevation myocardial infarction and received percutaneous coronary intervention, and studied systolic/diastolic function, hemodynamic consequences, adverse cardiac events, as well as 30-day and five-year outcomes in patients with and without Takotsubo effect.
Patients with Takotsubo effect showed significantly worse average peak systolic longitudinal strain (-9.5 ± 2.6% vs -11.1 ± 3.6%,
= 0.038), left ventricular ejection fraction (38.5 ± 6.8% vs 47.7 ± 8.7%,
= 0.000) and myocardial performance index (0.54 ± 0.17 vs 0.37 ± 0.15,
= 0.000) within 48 h of myocardial infarction. There was no significant difference between the two groups in diastolic ventricular filling pressures, hemodynamic consequences, and 30-day rehospitalization and mortality (Gehan-Breslow-Wilcoxon test:
0.157). However, patients with Takotsubo effect developed more major adverse cardiac events (log-rank test:
0.019) when tested at the five-year follow-up. Cox regression analysis revealed that age, hypotension, tricuspid annular plane systolic excursion, and Takotsubo effect were independent prediction factors for five-year major adverse cardiac events. The Doppler/tissue Doppler parameter E/e' correlated with MACE only in patients without Takotsubo effect.
Takotsubo effect secondary to anterior ST-segment elevation myocardial infarction predicts a worse long-term prognosis.
Details
- Title: Subtitle
- "Takotsubo effect" in patients with ST segment elevation myocardial infarction
- Creators
- Juan Lei - State University of New YorkJian Chen - Fifth Affiliated Hospital of Sun Yat-sen UniversityMegha Dogra - State University of New YorkMilena A Gebska - University of IowaSuchith Shetty - University of IowaRakesh Ponnapureddy - University of IowaShubha D Roy - University of IowaJingfeng Wang - Sun Yat-sen Memorial HospitalKan Liu - University of Iowa
- Resource Type
- Journal article
- Publication Details
- European heart journal. Acute cardiovascular care, Vol.9(7), pp.711-720
- DOI
- 10.1177/2048872620926680
- PMID
- 32508142
- ISSN
- 2048-8726
- eISSN
- 2048-8734
- Language
- English
- Date published
- 10/2020
- Academic Unit
- Radiology; Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984362737902771
Metrics
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