Although takotsubo cardiomyopathy (TTC) has been reported to have an excellent clinical
recovery, there are few data regarding clinical, laboratory, and echocardiographic
findings in TTC presenting as cardiogenic shock. We aimed to assess the differences
in these parameters between TTC presenting with and without cardiogenic shock.
Fifty patients were enrolled from the TTC registry database and divided according
to the presence of cardiogenic shock. Sixteen patients presented with cardiogenic
shock as initial presentation (S group), and 34 did not (NS group).
The S group had a higher prevalence of dyspnea (81% vs 38%, P = .005), pulmonary edema
(69% vs 29%, P = .009), and significant reversible mitral regurgitation (44% vs 15%,
P = .025) than the NS group. In addition, the S group had significantly higher troponin-I
(median, 8.2 vs 1.4 pg/mL; P = .043) and N-terminal prohormone brain natriuretic peptide
levels (median, 8831 vs 2348 pg/mL; P = .046). During follow-up (median, 3.1 years),
cardiac deaths associated with TTC itself and recurrences of TTC were not noted in
both groups.
The S group has a higher prevalence of heart failure symptoms, significant reversible
mitral regurgitation, and troponin-I and N-terminal prohormone brain natriuretic peptide
levels. However, with meticulous therapeutic strategies, prognosis of this syndrome
may be excellent irrespective of hemodynamic instability.
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