The Impact of Stressor Patterns on Clinical Features in Patients With Tako-tsubo Cardiomyopathy: Experiences of Two Tertiary Cardiovascular Centers
Article first published online: 1 OCT 2012
© 2012 Wiley Periodicals, Inc.
Volume 35, Issue 11, pages E6–E13, November 2012
How to Cite
Song, B. G., Yang, H. S., Hwang, H. K., Kang, G. H., Park, Y. H., Chun, W. J. and Oh, J. H. (2012), The Impact of Stressor Patterns on Clinical Features in Patients With Tako-tsubo Cardiomyopathy: Experiences of Two Tertiary Cardiovascular Centers. Clin Cardiol, 35: E6–E13. doi: 10.1002/clc.22053
- Issue published online: 14 NOV 2012
- Article first published online: 1 OCT 2012
- Manuscript Accepted: 1 AUG 2012
- Manuscript Received: 7 JUN 2012
Tako-tsubo cardiomyopathy (TTC) is typically triggered by an acute emotional or physical stress event. The aim of this study was to investigate the impact of stressor patterns on clinical features, laboratory parameters, and electrocardiographic and echocardiographic findings in patients with TTC.
Clinical features are different according to stressor patterns.
Of 137 patients enrolled from the TTC registry database, 14 patients had emotional triggers (E group), 96 had physical triggers (P group), and 27 had no triggers (N group).
Most clinical presentations and in-hospital courses were similar among the groups. However, the E group had a higher prevalence of chest pain (P = 0.006) and palpitation (P = 0.006), whereas the P group had a higher prevalence of cardiogenic shock (P = 0.040), than other groups. The P group had a significantly higher heart rate (P = 0.001); higher high-sensitivity C-reactive protein (P = 0.006), creatine kinase MB fraction (P = 0.045), and N terminal-probrain natriuretic peptide (P = 0.036) levels; higher left ventricular end-diastolic pressure (P = 0.019) and left ventricular end-systolic diameter (P = 0.002); but lower left ventricular ejection fraction (P = 0.018). The E group had lesser prevalence of apical ballooning pattern (P = 0.038) than other groups. The P group required more frequent use of inotropics (P = 0.041) and diuretics (P = 0.047) and had significantly longer intensive care unit (P = 0.014) and in-hospital stays (P = 0.001).
The clinical features of TTC are different according to preceding stressor patterns. The TTC group with preceding physical stressors was less likely to have preserved cardiovascular reserve and more likely to require hemodynamic support than other groups. The overall prognosis of TTC is excellent, regardless of triggering stressors. Clin. Cardiol. 2011 DOI: 10.1002/clc.22053
The authors have no funding, financial relationships, or conflicts of interest to disclose.