Clinical Predictors and Prognostic Impact of Recovery of Wall Motion Abnormalities in Takotsubo Syndrome: Results From the International Takotsubo Registry
Authors: Jurisic Stjepan , Gili Sebastiano , Cammann Victoria L. , Kato Ken , Szawan Konrad A. , D'Ascenzo Fabrizio , Jaguszewski Milosz , Bossone Eduardo , Citro Rodolfo , Sarcon Annahita , Napp L. Christian , Franke Jennifer , Noutsias Michel , Knorr Maike , Heiner Susanne , Burgdorf Christof , Koenig Wolfgang , Pott Alexander , Kherad Behrouz , Rajan Lawrence , Michels Guido , Pfister Roman , Cuneo Alessandro , Jacobshagen Claudius , Karakas Mahir , Meyer Philippe , Arroja Jose David , Banning Adrian , Cuculi Florim , Kobza Richard , Fischer Thomas A. , Vasankari Tuija , Airaksinen K. E. Juhani , Dworakowski Rafal , Kaiser Christoph , Osswald Stefan , Galiuto Leonarda , Dichtl Wolfgang , Chan Christina , Bridgman Paul , Beug Daniel , Delmas Clément , Lairez Olivier , Kozel Martin , Tousek Petr , Winchester David E. , Gilyarova Ekaterina , Shilova Alexandra , Gilyarov Mikhail , El‐Battrawy Ibrahim , Akin Ibrahim , Galuszka Jan , Ukena Christian , Poglajen Gregor , Paolini Carla , Bilato Claudio , Carrilho‐Ferreira Pedro , Pinto Fausto J. , Opolski Grzegorz , MacCarthy Philip , Kobayashi Yoshio , Prasad Abhiram , Rihal Charanjit S. , Widimský Petr , Horowitz John D. , Di Mario Carlo , Crea Filippo , Tschöpe Carsten , Pieske Burkert M. , Hasenfuß Gerd , Rottbauer Wolfgang , Braun‐Dullaeus Ruediger C. , Felix Stephan B. , Borggrefe Martin , Thiele Holger , Bauersachs Johann , Katus Hugo A. , Schunkert Heribert , Münzel Thomas , Böhm Michael , Bax Jeroen J. , Lüscher Thomas F. , Ruschitzka Frank , Ghadri Jelena R. , Templin Christian 
Published: November 2019

Background

Left ventricular (
LV
) recovery in takotsubo syndrome (
TTS
) occurs over a wide‐ranging interval, varying from hours to weeks. We sought to investigate the clinical predictors and prognostic impact of recovery time for
TTS
patients.

Methods and Results

TTS
patients from the International Takotsubo Registry were included in this study. Cut‐off for early
LV
recovery was determined to be 10 days after the acute event. Multivariable logistic regression was used to assess factors associated with the absence of early recovery. In‐hospital outcomes and 1‐year mortality were compared for patients with versus without early recovery. We analyzed 406 patients with comprehensive and serial imaging data regarding time to recovery. Of these, 191 (47.0%) had early
LV
recovery and 215 (53.0%) demonstrated late
LV
improvement. Patients without early recovery were more often male (12.6% versus 5.2%;
P
=0.011) and presented more frequently with typical
TTS
(76.3% versus 67.0%,
P
=0.040). Cardiac and inflammatory markers were higher in patients without early recovery than in those with early recovery. Patients without early recovery showed unfavorable 1‐year outcome compared with patients with early recovery (
P
=0.003). On multiple logistic regression, male sex, LV ejection fraction <45%, and acute neurologic disorders were associated with the absence of early recovery.

Conclusions

TTS patients without early
LV
recovery have different clinical characteristics and less favorable 1‐year outcome compared with patients with early recovery. The factors associated with the absence of early recovery included male sex, reduced LV ejection fraction, and acute neurologic events.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
01947621.