000098307 001__ 98307
000098307 005__ 20210126103232.0
000098307 0247_ $$2doi$$a10.1161/JAHA.119.013701
000098307 0248_ $$2sideral$$a122049
000098307 037__ $$aART-2019-122049
000098307 041__ $$aeng
000098307 100__ $$aUribarri, A.
000098307 245__ $$aShort- and Long-Term Prognosis of Patients With Takotsubo Syndrome Based on Different Triggers: Importance of the Physical Nature
000098307 260__ $$c2019
000098307 5060_ $$aAccess copy available to the general public$$fUnrestricted
000098307 5203_ $$aBackground
Takotsubo syndrome (TTS) is an acute reversible heart condition initially believed to represent a benign pathology attributable to its self-limiting clinical course; however, little is known about its prognosis based on different triggers. This study compared short- and long-term outcomes between TTS based on different triggers, focusing on various physical triggering events.
Methods and Results
We analyzed patients with a definitive TTS diagnosis recruited for the Spanish National Registry on TTS (RETAKO [Registry on Takotsubo Syndrome]). Short- and long-term outcomes were compared between different groups according to triggering factors. A total of 939 patients were included. An emotional trigger was detected in 340 patients (36.2%), a physical trigger in 293 patients (31.2%), and none could be identified in 306 patients (32.6%). The main physical triggers observed were infections (30.7%), followed by surgical procedures (22.5%), physical activities (18.4%), episodes of severe hypoxia (18.4%), and neurological events (9.9%). TTS triggered by physical factors showed higher mortality in the short and long term, and within this group, patients whose physical trigger was hypoxia were those who had a worse prognosis, in addition to being triggered by physical factors, including age >70 years, diabetes mellitus, left ventricular eyection fraction <30% and shock on admission, and increased long-term mortality risk.
Conclusions
TTS triggered by physical factors could present a worse prognosis in terms of mortality. Under the TTS label, there could be as yet undiscovered very different clinical profiles, whose differentiation could lead to individual better management, and therefore the perception of TTS as having a benign prognosis should be generally ruled out.
000098307 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000098307 590__ $$a4.605$$b2019
000098307 591__ $$aCARDIAC & CARDIOVASCULAR SYSTEMS$$b31 / 138 = 0.225$$c2019$$dQ1$$eT1
000098307 592__ $$a2.382$$b2019
000098307 593__ $$aCardiology and Cardiovascular Medicine$$c2019$$dQ1
000098307 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000098307 700__ $$aNunez-Gil, I.J.
000098307 700__ $$aConty, D.A.
000098307 700__ $$aVedia, O.
000098307 700__ $$aAlmendro-Delia, M.
000098307 700__ $$aCambra, A.D.
000098307 700__ $$aMartin-Garcia, A.C.
000098307 700__ $$aBarrionuevo-Sanchez, M.
000098307 700__ $$aMartinez-Selles, M.
000098307 700__ $$aRaposeiras-Roubin, S.
000098307 700__ $$aGuillen, M.
000098307 700__ $$aAcuna, J.M.G.
000098307 700__ $$aMatute-Blanco, L.
000098307 700__ $$0(orcid)0000-0002-4236-6954$$aVicente, J.A.L.$$uUniversidad de Zaragoza
000098307 700__ $$aFlecha, A.S.G.
000098307 700__ $$aAndres, M.
000098307 700__ $$aPerez-Castellanos, A.
000098307 700__ $$aLopez-Pais, J.
000098307 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000098307 773__ $$g8, 24 (2019), [12 pp]$$tJournal of the American Heart Association. Cardiovascular and cerebrovascular disease$$x2047-9980
000098307 8564_ $$s312624$$uhttps://zaguan.unizar.es/record/98307/files/texto_completo.pdf$$yVersión publicada
000098307 8564_ $$s2977989$$uhttps://zaguan.unizar.es/record/98307/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000098307 909CO $$ooai:zaguan.unizar.es:98307$$particulos$$pdriver
000098307 951__ $$a2021-01-26-09:28:02
000098307 980__ $$aARTICLE