Author: "Heiner, S" - Searchworks@Jio Institute Digital Library Search Results

Your search keyword '"Heiner, S"' showing total 45 results

Start Over Author "Heiner, S"

45 results on '"Heiner, S"'

1. Nephrectomy After High-Grade Renal Trauma is Associated With Higher Mortality: Results From the Multi-Institutional Genitourinary Trauma Study (MiGUTS)

Author: Heiner, S. Mitchell, Keihani, Sorena, McCormick, Benjamin J., Fang, Elisa, Hagedorn, Judith C., Voelzke, Bryan, Nocera, Alexander P., Selph, J. Patrick, Arya, Chirag S., Sensenig, Rachel L., Rezaee, Michael E., Moses, Rachel A., Dodgion, Christopher M., Higgins, Margaret M., Gupta, Shubham, Mukherjee, Kaushik, Majercik, Sarah, Smith, Brian P., Glavin, Katie, Broghammer, Joshua A., Schwartz, Ian, Elliott, Sean P., Breyer, Benjamin N., Becerra, Clara M. Castillejo, Baradaran, Nima, DeSoucy, Erik, Zakaluzny, Scott, Erickson, Bradley A., Miller, Brandi D., Santucci, Richard A., Askari, Reza, Carrick, Matthew M., Burks, Frank N., Norwood, Scott, Nirula, Raminder, and Myers, Jeremy B.
Published: 2021
Full Text: View/download PDF

2. Impact of atrial fibrillation on outcome in takotsubo syndrome: Data from the international Takotsubo registry

Author: El-Battrawy, I., Cammann, V. L., Kato, K., Szawan, K. A., Di Vece, D., Rossi, A., Wischnewsky, M., Hermes-Laufer, J., Gili, S., Citro, R., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, F., Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Arroja, J. D., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Juhani Airaksinen, K. E., Napp, L. C., Budnik, M., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., Kozel, M., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Kobayashi, Y., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Opolski, G., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, C., Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Duru, F., Borggrefe, M., Ghadri, J. R., Akin, I., Templin, C., Galiuto L. (ORCID:0000-0002-6831-479X), Crea F. (ORCID:0000-0001-9404-8846), El-Battrawy, I., Cammann, V. L., Kato, K., Szawan, K. A., Di Vece, D., Rossi, A., Wischnewsky, M., Hermes-Laufer, J., Gili, S., Citro, R., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, F., Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Arroja, J. D., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Juhani Airaksinen, K. E., Napp, L. C., Budnik, M., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., Kozel, M., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Kobayashi, Y., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Opolski, G., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, C., Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Duru, F., Borggrefe, M., Ghadri, J. R., Akin, I., Templin, C., Galiuto L. (ORCID:0000-0002-6831-479X), and Crea F. (ORCID:0000-0001-9404-8846)
Abstract: BACKGROUND: Atrial fibrillation (AF) is a major risk factor for mortality. The prevalence, clinical correlates, and prognostic impact of AF in Takotsubo syndrome (TTS) have not yet been investigated in a large patient cohort. This study aimed to investigate the prevalence, clinical correlates, and prognostic impact of AF in patients with TTS. METHODS AND RESULTS: Patients with TTS were enrolled from the International Takotsubo Registry, which is a multinational network with 26 participating centers in Europe and the United States. Patients were dichotomized according to the presence or absence of AF at the time of admission. Of 1584 patients with TTS, 112 (7.1%) had AF. The mean age was higher (P<0.001), and there were fewer women (P=0.046) in the AF than in the non-AF group. Left ventricular ejection fraction was significantly lower (P=0.001), and cardiogenic shock was more often observed (P<0.001) in the AF group. Both in-hospital (P<0.001) and long-term mortality (P<0.001) were higher in the AF group. Multivariable Cox regression analysis revealed that AF was independently associated with higher long-term mortality (hazard ratio, 2.31; 95% CI, 1.50– 3.55; P<0.001). Among patients with AF on admission, 42% had no known history of AF before the acute TTS event, and such patients had comparable in-hospital and long-term outcomes compared with those with a history of AF. CONCLUSIONS: In patients presenting with TTS, AF on admission is significantly associated with increased in-hospital and long-term mortality rates. Whether antiarrhythmics and/or cardioversion are beneficial in TTS with AF should thus be tested in a future trial. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01947621.
Published: 2021

3. Prognostic impact of acute pulmonary triggers in patients with takotsubo syndrome: new insights from the International Takotsubo Registry

Author: Kato, K., Cammann, V. L., Napp, L. C., Szawan, K. A., Micek, J., Dreiding, S., Levinson, R. A., Petkova, V., Wurdinger, M., Patrascu, A., Sumalinog, R., Gili, S., Clarenbach, C. F., Kohler, M., Wischnewsky, M., Citro, R., Vecchione, C., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, Francesca, Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Roffi, M., Banning, A., Wolfrum, M., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Budnik, M., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., El-Battrawy, I., Akin, I., Kozel, M., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Sano, M., Ishibashi, I., Takahara, M., Himi, T., Kobayashi, Y., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Opolski, G., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Borggrefe, M., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, Clara, Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Templin, C., D'Ascenzo F., Galiuto L. (ORCID:0000-0002-6831-479X), Di Mario C., Crea F. (ORCID:0000-0001-9404-8846), Kato, K., Cammann, V. L., Napp, L. C., Szawan, K. A., Micek, J., Dreiding, S., Levinson, R. A., Petkova, V., Wurdinger, M., Patrascu, A., Sumalinog, R., Gili, S., Clarenbach, C. F., Kohler, M., Wischnewsky, M., Citro, R., Vecchione, C., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, Francesca, Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Roffi, M., Banning, A., Wolfrum, M., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Budnik, M., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., El-Battrawy, I., Akin, I., Kozel, M., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Sano, M., Ishibashi, I., Takahara, M., Himi, T., Kobayashi, Y., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Opolski, G., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Borggrefe, M., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, Clara, Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Templin, C., D'Ascenzo F., Galiuto L. (ORCID:0000-0002-6831-479X), Di Mario C., and Crea F. (ORCID:0000-0001-9404-8846)
Abstract: Aims: Acute pulmonary disorders are known physical triggers of takotsubo syndrome (TTS). This study aimed to investigate prevalence of acute pulmonary triggers in patients with TTS and their impact on outcomes. Methods and results: Patients with TTS were enrolled from the International Takotsubo Registry and screened for triggering factors and comorbidities. Patients were categorized into three groups (acute pulmonary trigger, chronic lung disease, and no lung disease) to compare clinical characteristics and outcomes. Of the 1670 included patients with TTS, 123 (7%) were identified with an acute pulmonary trigger, and 194 (12%) had a known history of chronic lung disease. The incidence of cardiogenic shock was highest in patients with an acute pulmonary trigger compared with those with chronic lung disease or without lung disease (17% vs. 10% vs. 9%, P = 0.017). In-hospital mortality was also higher in patients with an acute pulmonary trigger than in the other two groups, although not significantly (5.7% vs. 1.5% vs. 4.2%, P = 0.13). Survival analysis demonstrated that patients with an acute pulmonary trigger had the worst long-term outcome (P = 0.002). The presence of an acute pulmonary trigger was independently associated with worse long-term mortality (hazard ratio 2.12, 95% confidence interval 1.33–3.38; P = 0.002). Conclusions: The present study demonstrates that TTS is related to acute pulmonary triggers in 7% of all TTS patients, which accounts for 21% of patients with physical triggers. The presence of acute pulmonary trigger is associated with a severe in-hospital course and a worse long-term outcome.
Published: 2021

4. Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry

Author: D'Ascenzo, Francesca, Gili, S., Bertaina, M., Iannaccone, M., Cammann, V. L., Di Vece, D., Kato, K., Saglietto, A., Szawan, K. A., Frangieh, A. H., Boffini, B., Annaratone, M., Sarcon, A., Levinson, R. A., Franke, J., Napp, L. C., Jaguszewski, M., Noutsias, M., Munzel, T., Knorr, M., Heiner, S., Katus, H. A., Burgdorf, C., Schunkert, H., Thiele, H., Bauersachs, J., Tschope, C., Pieske, B. M., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Hasenfuss, G., Karakas, M., Koenig, W., Rottbauer, W., Said, S. M., Braun-Dullaeus, R. C., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Opolski, G., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Crea, Filippo, Dichtl, W., Franz, W. M., Empen, K., Felix, S. B., Delmas, C., Lairez, O., El-Battrawy, I., Akin, I., Borggrefe, M., Horowitz, J. D., Kozel, M., Tousek, P., Widimsky, P., Gilyarova, E., Shilova, A., Gilyarov, M., Biondi-Zoccai, G., Winchester, D. E., Ukena, C., Neuhaus, M., Bax, J. J., Prasad, A., Di Mario, C., Bohm, M., Gasparini, M., Ruschitzka, F., Bossone, E., Citro, R., Rinaldi, M., De Ferrari, G. M., Luscher, T., Ghadri, J. R., Templin, C., D'Ascenzo F., Galiuto L. (ORCID:0000-0002-6831-479X), Crea F. (ORCID:0000-0001-9404-8846), D'Ascenzo, Francesca, Gili, S., Bertaina, M., Iannaccone, M., Cammann, V. L., Di Vece, D., Kato, K., Saglietto, A., Szawan, K. A., Frangieh, A. H., Boffini, B., Annaratone, M., Sarcon, A., Levinson, R. A., Franke, J., Napp, L. C., Jaguszewski, M., Noutsias, M., Munzel, T., Knorr, M., Heiner, S., Katus, H. A., Burgdorf, C., Schunkert, H., Thiele, H., Bauersachs, J., Tschope, C., Pieske, B. M., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Hasenfuss, G., Karakas, M., Koenig, W., Rottbauer, W., Said, S. M., Braun-Dullaeus, R. C., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Opolski, G., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Crea, Filippo, Dichtl, W., Franz, W. M., Empen, K., Felix, S. B., Delmas, C., Lairez, O., El-Battrawy, I., Akin, I., Borggrefe, M., Horowitz, J. D., Kozel, M., Tousek, P., Widimsky, P., Gilyarova, E., Shilova, A., Gilyarov, M., Biondi-Zoccai, G., Winchester, D. E., Ukena, C., Neuhaus, M., Bax, J. J., Prasad, A., Di Mario, C., Bohm, M., Gasparini, M., Ruschitzka, F., Bossone, E., Citro, R., Rinaldi, M., De Ferrari, G. M., Luscher, T., Ghadri, J. R., Templin, C., D'Ascenzo F., Galiuto L. (ORCID:0000-0002-6831-479X), and Crea F. (ORCID:0000-0001-9404-8846)
Abstract: Aims: The aim of the present study was to investigate the impact of aspirin on prognosis in takotsubo syndrome (TTS). Methods and results: Patients from the International Takotsubo (InterTAK) Registry were categorized into two groups based on aspirin prescription at discharge. A comparison of clinical outcomes between groups was performed using an adjusted analysis with propensity score (PS) stratification; results from the unadjusted analysis were also reported to note the effect of the PS adjustment. Major adverse cardiac and cerebrovascular events (MACCE: a composite of death, myocardial infarction, TTS recurrence, stroke or transient ischaemic attack) were assessed at 30-day and 5-year follow-up. A total of 1533 TTS patients with known status regarding aspirin prescription at discharge were included. According to the adjusted analysis based on PS stratification, aspirin was not associated with a lower hazard of MACCE at 30-day [hazard ratio (HR) 1.24, 95% confidence interval (CI) 0.50–3.04, P = 0.64] or 5-year follow-up (HR 1.11, 95% CI 0.78–1.58, P = 0.58). These results were confirmed by sensitivity analyses performed with alternative PS-based methods, i.e. covariate adjustment and inverse probability of treatment weighting. Conclusion: In the present study, no association was found between aspirin use in TTS patients and a reduced risk of MACCE at 30-day and 5-year follow-up. These findings should be confirmed in adequately powered randomized controlled trials. ClinicalTrials.gov Identifier: NCT01947621.
Published: 2020

5. Age-Related Variations in Takotsubo Syndrome

Author: Cammann, V. L., Szawan, K. A., Stahli, B. E., Kato, K., Budnik, M., Wischnewsky, M., Dreiding, S., Levinson, R. A., Di Vece, D., Gili, S., Citro, R., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, F., Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Roffi, M., Banning, A., Wolfrum, M., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Napp, L. C., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., El-Battrawy, I., Akin, I., Polednikova, K., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Kobayashi, Y., Shoji, T., Ishibashi, I., Takahara, M., Himi, T., Din, J., Al-Shammari, A., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Borggrefe, M., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, C., Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Opolski, G., Templin, C., Galiuto L. (ORCID:0000-0002-6831-479X), Crea F. (ORCID:0000-0001-9404-8846), Cammann, V. L., Szawan, K. A., Stahli, B. E., Kato, K., Budnik, M., Wischnewsky, M., Dreiding, S., Levinson, R. A., Di Vece, D., Gili, S., Citro, R., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, F., Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Roffi, M., Banning, A., Wolfrum, M., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Napp, L. C., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., El-Battrawy, I., Akin, I., Polednikova, K., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Kobayashi, Y., Shoji, T., Ishibashi, I., Takahara, M., Himi, T., Din, J., Al-Shammari, A., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Borggrefe, M., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, C., Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Opolski, G., Templin, C., Galiuto L. (ORCID:0000-0002-6831-479X), and Crea F. (ORCID:0000-0001-9404-8846)
Abstract: Background: Takotsubo syndrome (TTS) occurs predominantly in post-menopausal women but is also found in younger patients. Objectives: This study aimed to investigate age-related differences in TTS. Methods: Patients diagnosed with TTS and enrolled in the International Takotsubo Registry between January 2011 and February 2017 were included in this analysis and were stratified by age (younger: ≤50 years, middle-age: 51 to 74 years, elderly: ≥75 years). Baseline characteristics, hospital course, as well as short- and long-term mortality were compared among groups. Results: Of 2,098 TTS patients, 242 (11.5%) patients were ≤50 years of age, 1,194 (56.9%) were 51 to 74 years of age, and 662 (31.6%) were ≥75 years of age. Younger patients were more often men (12.4% vs. 10.9% vs. 6.3%; p = 0.002) and had an increased prevalence of acute neurological (16.3% vs. 8.4% vs. 8.8%; p = 0.001) or psychiatric disorders (14.1% vs. 10.3% vs. 5.6%; p < 0.001) compared with middle-aged and elderly TTS patients. Furthermore, younger patients had more often cardiogenic shock (15.3% vs. 9.1% vs. 8.1%; p = 0.004) and had a numerically higher in-hospital mortality (6.6% vs. 3.6% vs. 5.1%; p = 0.07). At multivariable analysis, younger (odds ratio: 1.60; 95% confidence interval: 0.86 to 3.01; p = 0.14) and older age (odds ratio: 1.09; 95% confidence interval: 0.66 to 1.80; p = 0.75) were not independently associated with in-hospital mortality using the middle-aged group as a reference. There were no differences in 60-day mortality rates among groups. Conclusions: A substantial proportion of TTS patients are younger than 50 years of age. TTS is associated with severe complications requiring intensive care, particularly in younger patients.
Published: 2020

6. Cardiac arrest in takotsubo syndrome: results from the InterTAK Registry

Author: Gili, S, Cammann, Vl, Schlossbauer, Sa, Kato, K, D'Ascenzo, F, Di Vece, D, Jurisic, S, Micek, J, Obeid, S, Bacchi, B, Szawan, Ka, Famos, F, Sarcon, A, Levinson, R, Ding, Kj, Seifert, B, Lenoir, O, Bossone, E, Citro, R, Franke, J, Napp, Lc, Jaguszewski, M, Noutsias, M, Munzel, T, Knorr, M, Heiner, S, Katus, Ha, Burgdorf, C, Schunkert, H, Thiele, H, Bauersachs, J, Tschope, C, Pieske, Bm, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Hasenfuss, G, Karakas, M, Koenig, W, Rottbauer, W, Said, Sm, Braun-Dullaeus, Rc, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kej, Opolski, G, Dworakowski, R, MacCarthy, P, Kaiser, C, Osswald, S, Galiuto, L, Crea, F, Dichtl, W, Empen, K, Felix, Sb, Delmas, C, Lairez, O, El-Battrawy, I, Akin, I, Borggrefe, M, Gilyarova, E, Shilova, A, Gilyarov, M, Horowitz, Jd, Kozel, M, Tousek, P, Widimsky, P, Winchester, De, Ukena, C, Gaita, F, Di Mario, C, Wischnewsky, Mb, Bax, Jj, Prasad, A, Bohm, M, Ruschitzka, F, Luscher, Tf, Ghadri, Jr, Templin, C, Galiuto, L (ORCID:0000-0002-6831-479X), Crea, F (ORCID:0000-0001-9404-8846), Gili, S, Cammann, Vl, Schlossbauer, Sa, Kato, K, D'Ascenzo, F, Di Vece, D, Jurisic, S, Micek, J, Obeid, S, Bacchi, B, Szawan, Ka, Famos, F, Sarcon, A, Levinson, R, Ding, Kj, Seifert, B, Lenoir, O, Bossone, E, Citro, R, Franke, J, Napp, Lc, Jaguszewski, M, Noutsias, M, Munzel, T, Knorr, M, Heiner, S, Katus, Ha, Burgdorf, C, Schunkert, H, Thiele, H, Bauersachs, J, Tschope, C, Pieske, Bm, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Hasenfuss, G, Karakas, M, Koenig, W, Rottbauer, W, Said, Sm, Braun-Dullaeus, Rc, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kej, Opolski, G, Dworakowski, R, MacCarthy, P, Kaiser, C, Osswald, S, Galiuto, L, Crea, F, Dichtl, W, Empen, K, Felix, Sb, Delmas, C, Lairez, O, El-Battrawy, I, Akin, I, Borggrefe, M, Gilyarova, E, Shilova, A, Gilyarov, M, Horowitz, Jd, Kozel, M, Tousek, P, Widimsky, P, Winchester, De, Ukena, C, Gaita, F, Di Mario, C, Wischnewsky, Mb, Bax, Jj, Prasad, A, Bohm, M, Ruschitzka, F, Luscher, Tf, Ghadri, Jr, Templin, C, Galiuto, L (ORCID:0000-0002-6831-479X), and Crea, F (ORCID:0000-0001-9404-8846)
Abstract: Aims We aimed to evaluate the frequency, clinical features, and prognostic implications of cardiac arrest (CA) in takotsubo syndrome (TTS).Methods and results We reviewed the records of patients with CA and known heart rhythm from the International Takotsubo Registry. The main outcomes were 60-day and 5-year mortality. In addition, predictors of mortality and predictors of CA during the acute TTS phase were assessed. Of 2098 patients, 103 patients with CA and known heart rhythm during CA were included. Compared with patients without CA, CA patients were more likely to be younger, male, and have apical TTS, atrial fibrillation (AF), neurologic comorbidities, physical triggers, and longer corrected QT-interval and lower left ventricular ejection fraction on admission. In all, 57.1% of patients with CA at admission had ventricular fibrillation/tachycardia, while 73.7% of patients with CA in the acute phase had asystole/pulseless electrical activity. Patients with CA showed higher 60-day (40.3% vs. 4.0%, P < 0.001) and 5-year mortality (68.9% vs. 16.7%, P < 0.001) than patients without CA. T-wave inversion and intracranial haemorrhage were independently associated with higher 60-day mortality after CA, whereas female gender was associated with lower 60-day mortality. In the acute phase, CA occurred less frequently in females and more frequently in patients with AF, ST-segment elevation, and higher C-reactive protein on admission.Conclusions Cardiac arrest is relatively frequent in TTS and is associated with higher short- and long-term mortality. Clinical and electrocardiographic parameters independently predicted mortality after CA.
Published: 2019

7. Outcomes Associated With Cardiogenic Shock in Takotsubo Syndrome: Results From the International Takotsubo Registry

Author: Di Vece, D., Citro, R., Cammann, V. L., Kato, K., Gili, S., Szawan, K. A., Micek, J., Jurisic, S., Ding, K. J., Bacchi, B., Schwyzer, M., Candreva, A., Bossone, E., D'Ascenzo, F., Sarcon, A., Franke, J., Napp, L. C., Jaguszewski, M., Noutsias, M., Munzel, T., Knorr, M., Heiner, S., Katus, H. A., Burgdorf, C., Schunkert, H., Thiele, H., Bauersachs, J., Tschope, C., Pieske, B. M., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Hasenfuss, G., Karakas, M., Koenig, W., Rottbauer, W., Said, S. M., Braun-Dullaeus, R. C., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Opolski, G., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Crea, Filippo, Dichtl, W., Empen, K., Felix, S. B., Delmas, C., Lairez, O., El-Battrawy, I., Akin, I., Borggrefe, M., Gilyarova, E., Shilova, A., Gilyarov, M., Horowitz, J., Kozel, M., Tousek, P., Widimsky, P., Winchester, D. E., Ukena, C., Di Mario, Clara, Prasad, A., Bohm, M., Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Templin, C., Galiuto L. (ORCID:0000-0002-6831-479X), Crea F. (ORCID:0000-0001-9404-8846), Di Mario C., Di Vece, D., Citro, R., Cammann, V. L., Kato, K., Gili, S., Szawan, K. A., Micek, J., Jurisic, S., Ding, K. J., Bacchi, B., Schwyzer, M., Candreva, A., Bossone, E., D'Ascenzo, F., Sarcon, A., Franke, J., Napp, L. C., Jaguszewski, M., Noutsias, M., Munzel, T., Knorr, M., Heiner, S., Katus, H. A., Burgdorf, C., Schunkert, H., Thiele, H., Bauersachs, J., Tschope, C., Pieske, B. M., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Hasenfuss, G., Karakas, M., Koenig, W., Rottbauer, W., Said, S. M., Braun-Dullaeus, R. C., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Opolski, G., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Crea, Filippo, Dichtl, W., Empen, K., Felix, S. B., Delmas, C., Lairez, O., El-Battrawy, I., Akin, I., Borggrefe, M., Gilyarova, E., Shilova, A., Gilyarov, M., Horowitz, J., Kozel, M., Tousek, P., Widimsky, P., Winchester, D. E., Ukena, C., Di Mario, Clara, Prasad, A., Bohm, M., Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Templin, C., Galiuto L. (ORCID:0000-0002-6831-479X), Crea F. (ORCID:0000-0001-9404-8846), and Di Mario C.
Abstract: n/a
Published: 2019

8. Long-Term Prognosis of Patients With Takotsubo Syndrome

Author: Ghadri, Jr, Kato, K, Cammann, Vl, Gili, S, Jurisic, S, Di Vece, D, Candreva, A, Ding, Kj, Micek, J, Szawan, Ka, Bacchi, B, Bianchi, R, Levinson, Ra, Wischnewsky, M, Seifert, B, Schlossbauer, Sa, Citro, R, Bossone, E, Münzel, T, Knorr, M, Heiner, S, D'Ascenzo, F, Franke, J, Sarcon, A, Napp, Lc, Jaguszewski, M, Noutsias, M, Katus, Ha, Burgdorf, C, Schunkert, H, Thiele, H, Bauersachs, J, Tschöpe, C, Pieske, Bm, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Hasenfuß, G, Karakas, M, Koenig, W, Rottbauer, W, Said, Sm, Braun-Dullaeus, Rc, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kej, Opolski, G, Dworakowski, R, Maccarthy, P, Kaiser, C, Osswald, S, Galiuto, Leonarda, Crea, Filippo, Dichtl, W, Empen, K, Felix, Sb, Delmas, C, Lairez, O, El-Battrawy, I, Akin, I, Borggrefe, M, Horowitz, J, Kozel, M, Tousek, P, Widimský, P, Gilyarova, E, Shilova, A, Gilyarov, M, Winchester, De, Ukena, C, Bax, Jj, Prasad, A, Böhm, M, Lüscher, Tf, Ruschitzka, F, Templin, C., Galiuto L (ORCID:0000-0002-6831-479X), Crea F (ORCID:0000-0001-9404-8846), Ghadri, Jr, Kato, K, Cammann, Vl, Gili, S, Jurisic, S, Di Vece, D, Candreva, A, Ding, Kj, Micek, J, Szawan, Ka, Bacchi, B, Bianchi, R, Levinson, Ra, Wischnewsky, M, Seifert, B, Schlossbauer, Sa, Citro, R, Bossone, E, Münzel, T, Knorr, M, Heiner, S, D'Ascenzo, F, Franke, J, Sarcon, A, Napp, Lc, Jaguszewski, M, Noutsias, M, Katus, Ha, Burgdorf, C, Schunkert, H, Thiele, H, Bauersachs, J, Tschöpe, C, Pieske, Bm, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Hasenfuß, G, Karakas, M, Koenig, W, Rottbauer, W, Said, Sm, Braun-Dullaeus, Rc, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kej, Opolski, G, Dworakowski, R, Maccarthy, P, Kaiser, C, Osswald, S, Galiuto, Leonarda, Crea, Filippo, Dichtl, W, Empen, K, Felix, Sb, Delmas, C, Lairez, O, El-Battrawy, I, Akin, I, Borggrefe, M, Horowitz, J, Kozel, M, Tousek, P, Widimský, P, Gilyarova, E, Shilova, A, Gilyarov, M, Winchester, De, Ukena, C, Bax, Jj, Prasad, A, Böhm, M, Lüscher, Tf, Ruschitzka, F, Templin, C., Galiuto L (ORCID:0000-0002-6831-479X), and Crea F (ORCID:0000-0001-9404-8846)
Abstract: Background: Prognosis of Takotsubo syndrome (TTS) remains controversial due to scarcity of available data. Additionally, the effect of the triggering factors remains elusive. Objectives: This study compared prognosis between TTS and acute coronary syndrome (ACS) patients and investigated short- and long-term outcomes in TTS based on different triggers. Methods: Patients with TTS were enrolled from the International Takotsubo Registry. Long-term mortality of patients with TTS was compared to an age- and sex-matched cohort of patients with ACS. In addition, short- and long-term outcomes were compared between different groups according to triggering conditions. Results: Overall, TTS patients had a comparable long-term mortality risk with ACS patients. Of 1,613 TTS patients, an emotional trigger was detected in 485 patients (30%). Of 630 patients (39%) related to physical triggers, 98 patients (6%) had acute neurologic disorders, while in the other 532 patients (33%), physical activities, medical conditions, or procedures were the triggering conditions. The remaining 498 patients (31%) had no identifiable trigger. TTS patients related to physical stress showed higher mortality rates than ACS patients during long-term follow-up, whereas patients related to emotional stress had better outcomes compared with ACS patients. Conclusions: Overall, TTS patients had long-term outcomes comparable to age- and sex-matched ACS patients. Also, we demonstrated that TTS can either be benign or a life-threating condition depending on the inciting stress factor. We propose a new classification based on triggers, which can serve as a clinical tool to predict short- and long-term outcomes of TTS. (International Takotsubo Registry [InterTAK Registry]; NCT01947621)
Published: 2018

9. What is the fate of artificial urinary sphincters among men undergoing repetitive bladder cancer treatment?

Author: Heiner, S. Mitchell, primary, Viers, Boyd R., additional, Rivera, Marcelino E., additional, Linder, Brian J., additional, and Elliott, Daniel S., additional
Published: 2018
Full Text: View/download PDF

10. Hydrophilic photolabelling of glycopeptides from the murine liver–intestine (LI) cadherin recognition domain

Author: HEINER, S, primary, DETERT, H, additional, KUHN, A, additional, and KUNZ, H, additional
Published: 2006
Full Text: View/download PDF

11. An Easy Synthetic Route to Heteroleptic Samarium Monoalkoxides for Ring-Opening Polymerization Initiators. Molecular Structures of [(C<INF>5</INF>Hi-Pr<INF>4</INF>)SmI(THF)<INF>2</INF>]<INF>2</INF>, SmI<INF>2</INF>Ot-Bu(THF)<INF>4</INF>, and (C<INF>4</INF>Me<INF>4</INF>P)<INF>2</INF>SmOt-Bu(THF)

Author: Barbier-Baudry, D., Heiner, S., Kubicki, M. M., Vigier, E., Visseaux, M., and Hafid, A.
Abstract: Samarium^III monoalkoxides bearing two, one, or no cyclopentadienyl type spectator ligands are easily synthesized by monoelectronic oxidation with tert-butylperoxide of the corresponding samarium^II precursors. These monoalkoxides are single-site initiators for ring-opening polymerization.
Published: 2001

12. Give audiences quality display

Author: Heiner, Sally
Published: 1991

13. Professional Write Plus provides power and speed for executives

Author: Heiner, Sally
Published: 1991

14. Competitive Legacy shows Wordstar has come of age

Author: Heiner, Sally
Published: 1991

15. Our experience with proton pump inhibitor (PPI) use in our local long-term care facility.

Author: Harrington BC, Dickey L, and Heiner S
Published: 2008

16. Prediction of short‐ and long‐term mortality in takotsubo syndrome: the InterTAK Prognostic Score

Author: Thomas Münzel, Yoshio Kobayashi, Wolfgang Koenig, Hugo A. Katus, Paul Bridgman, Christina Chan, Ioana Sorici-Barb, Eduardo Bossone, Gregor Poglajen, Abhiram Prasad, Fabrizio D'Ascenzo, Jelena R. Ghadri, Monika Budnik, Konrad A. Szawan, Fausto J. Pinto, David E. Winchester, Guido Michels, Carlo Di Mario, Thomas Fischer, Matteo Bianco, Jerold S. Shinbane, Burkert Pieske, Alessandro Candreva, Rodolfo Citro, P. Christian Schulze, Annahita Sarcon, Kan Liu, Christian Ukena, Christoph Kaiser, Martin Borggrefe, Florim Cuculi, Stefan Osswald, Behrouz Kherad, Heribert Schunkert, Jeroen J. Bax, Maike Knorr, Ken Kato, Petr Widimský, Alexandra Shilova, Frank Ruschitzka, Martin Kozel, Victoria L. Cammann, Roman Pfister, Olivier Lairez, Michael Neuhaus, Alessandro Cuneo, Wolfgang Rottbauer, Ibrahim Akin, Lucas Jörg, Christian Hauck, L. Christian Napp, Holger Thiele, Manfred Wischnewsky, K.E. Juhani Airaksinen, Hans Rickli, Tuija Vasankari, Carla Paolini, Lars S. Maier, Philippe Meyer, Adrian P. Banning, Richard Kobza, Beatrice Bacchi, Miłosz Jaguszewski, Rafal Dworakowski, Michael Böhm, Claudio Bilato, Mahir Karakas, Philip MacCarthy, Mikhail Gilyarov, Charanjit S. Rihal, Alexander Pott, Claudius Jacobshagen, Clément Delmas, Jose David Arroja, Ibrahim El-Battrawy, Filippo Crea, Carsten Tschöpe, Pedro Carrilho-Ferreira, Ekaterina Gilyarova, Jennifer Franke, Daniel Beug, Ruediger C. Braun-Dullaeus, John D. Horowitz, Thanh H Nguyen, Sebastiano Gili, Christof Burgdorf, Jan Galuszka, Leonarda Galiuto, Grzegorz Opolski, Susanne Heiner, Johann Bauersachs, Christian Templin, Petr Tousek, Michel Noutsias, Lawrence Rajan, Stephan B. Felix, Wolfgang Dichtl, Thomas F. Lüscher, Gerd Hasenfuß, Wischnewsky, Mb, Candreva, A, Bacchi, B, Cammann, Vl, Kato, K, Szawan, Ka, Gili, S, D'Ascenzo, F, Dichtl, W, Citro, R, Bossone, E, Neuhaus, M, Franke, J, Sorici-Barb, I, Jaguszewski, M, Noutsias, M, Knorr, M, Heiner, S, Burgdorf, C, Kherad, B, Tschope, C, Sarcon, A, Shinbane, J, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Karakas, M, Koenig, W, Pott, A, Meyer, P, Arroja, Jd, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kej, Napp, Lc, Budnik, M, Dworakowski, R, Maccarthy, P, Kaiser, C, Osswald, S, Galiuto, L, Chan, C, Bridgman, P, Beug, D, Delmas, C, Lairez, O, El-Battrawy, I, Akin, I, Gilyarova, E, Shilova, A, Gilyarov, M, Kozel, M, Tousek, P, Winchester, De, Galuszka, J, Ukena, C, Poglajen, G, Carrilho-Ferreira, P, Hauck, C, Paolini, C, Bilato, C, Prasad, A, Rihal, C, Liu, K, Schulze, Pc, Bianco, M, Jorg, L, Rickli, H, Nguyen, Th, Kobayashi, Y, Bohm, M, Maier, L, Pinto, Fj, Widimsky, P, Borggrefe, M, Felix, Sb, Opolski, G, Braun-Dullaeus, Rc, Rottbauer, W, Hasenfuss, G, Pieske, Bm, Schunkert, H, Thiele, H, Bauersachs, J, Katus, Ha, Horowitz, J, Di Mario, C, Munzel, T, Crea, F, Bax, Jj, Luscher, Tf, Ruschitzka, F, Ghadri, Jr, Templin, C, and Repositório da Universidade de Lisboa
Subjects: Male, Research design, medicine.medical_specialty, MEDLINE, 030204 cardiovascular system & hematology, Prognostic score, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Takotsubo Cardiomyopathy, Internal medicine, medicine, Humans, 030212 general & internal medicine, Survival analysis, Aged, Aged, 80 and over, Takotsubo syndrome, business.industry, Stroke Volume, Stroke volume, Middle Aged, Prognosis, medicine.disease, Survival Analysis, 3. Good health, Research Design, Heart failure, Cardiology, Female, Long term mortality, Cardiology and Cardiovascular Medicine, business
Abstract: © 2019 The Authors European Journal of Heart Failure © 2019 European Society of Cardiology, Recent evidence suggests comparable in‐hospital and long‐term outcomes between takotsubo syndrome (TTS) and acute coronary syndrome. Medical scoring systems are practical tools for decision making and prognostic assessment. However, TTS‐specific scoring systems for risk stratification have not yet been established. Recently, classification based on triggering conditions proved useful in predicting adverse outcomes in TTS (InterTAK Classification).1 Since clinical parameters other than triggering conditions can be associated with adverse outcomes in TTS, such as systolic blood pressure and heart rate, the present study aimed to establish a scoring system combining triggering factors with other important but easily‐ obtainable clinical parameters of daily clinical practice., C.T. has been supported by the H.H. Sheikh Khalifa bin Hamad Al-Thani Research Programme and the Swiss Heart Foundation. L.S.M. was supported by EU HORIZON 2020 (SILICOFCM ID777204). The InterTAK Registry is supported by the Biss Davies Charitable Trust.
Published: 2019
Full Text: View/download PDF

17. Prognostic impact of acute pulmonary triggers in patients with Takotsubo syndrome : new insights from the International Takotsubo Registry

Author: Wolfgang Koenig, John D. Horowitz, Hugo A. Katus, Paul Bridgman, Abhiram Prasad, Carlo Di Mario, Alessandro Cuneo, Johann Bauersachs, Jeroen J. Bax, Mathias Wolfrum, Carsten Tschöpe, Masanori Sano, Vanya Petkova, Lucas Jörg, Fausto J. Pinto, Petr Widimský, Masayuki Takahara, Rodolfo Citro, Iwao Ishibashi, Frank Ruschitzka, Thomas Münzel, Carmine Vecchione, Wolfgang Dichtl, Jan Galuszka, Kan Liu, Leonarda Galiuto, Grzegorz Opolski, Jozef Micek, Susanne Heiner, Florim Cuculi, Gerd Hasenfuß, Jerold S. Shinbane, Maike Knorr, Sebastiano Gili, Filippo Crea, Michael Würdinger, Alexandra Shilova, Malcolm Kohler, Lawrence Rajan, Christian F Clarenbach, Rena A. Levinson, Mikhail Gilyarov, Alexander Pott, Roman Pfister, Ekaterina Gilyarova, Claudius Jacobshagen, Adrian P. Banning, Michael Neuhaus, Jennifer Franke, Christian Templin, Christof Burgdorf, Daniel Beug, K.E. Juhani Airaksinen, Victoria L. Cammann, Thanh H Nguyen, Rafael Sumalinog, Monika Budnik, Wolfgang Rottbauer, Yoshio Kobayashi, Petr Tousek, Stephan B. Felix, Marco Roffi, Michael Böhm, Konrad A. Szawan, Toshiharu Himi, Ibrahim Akin, Christina Chan, Thomas F. Lüscher, Rafal Dworakowski, Annahita Sarcon, Ibrahim El-Battrawy, Miłosz Jaguszewski, Alexandru Patrascu, Eduardo Bossone, David E. Winchester, Michel Noutsias, Guido Michels, Gregor Poglajen, Christian Hauck, Fabrizio D'Ascenzo, Burkert Pieske, Christian Ukena, Thomas Fischer, Matteo Bianco, Lars S. Maier, Christoph Kaiser, Philippe Meyer, P. Christian Schulze, Behrouz Kherad, Gonçalo Pestana, Claudio Bilato, Ken Kato, Martin Kozel, Charanjit S. Rihal, Clément Delmas, Stefan Osswald, Olivier Lairez, Jelena R. Ghadri, Martin Borggrefe, Philip MacCarthy, Heribert Schunkert, Manfred Wischnewsky, Sara Dreiding, Hans Rickli, Tuija Vasankari, L. Christian Napp, Holger Thiele, Richard Kobza, Carla Paolini, Benjamin Meder, Mahir Karakas, Pedro Carrilho-Ferreira, Ruediger C. Braun-Dullaeus, Kato, K., Cammann, V. L., Napp, L. C., Szawan, K. A., Micek, J., Dreiding, S., Levinson, R. A., Petkova, V., Wurdinger, M., Patrascu, A., Sumalinog, R., Gili, S., Clarenbach, C. F., Kohler, M., Wischnewsky, M., Citro, R., Vecchione, C., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, F., Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Roffi, M., Banning, A., Wolfrum, M., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Budnik, M., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, L., Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., El-Battrawy, I., Akin, I., Kozel, M., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Sano, M., Ishibashi, I., Takahara, M., Himi, T., Kobayashi, Y., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Opolski, G., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Borggrefe, M., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, C., Munzel, T., Crea, F., Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Templin, C., and Repositório da Universidade de Lisboa
Subjects: medicine.medical_specialty, Acute respiratory insufficiency, acute respiratory insufficiency, Shock, Cardiogenic, 030204 cardiovascular system & hematology, Broken heart syndrome, chronic obstructive pulmonary disease, 03 medical and health sciences, 0302 clinical medicine, Takotsubo Cardiomyopathy, Original Research Articles, Internal medicine, medicine, Humans, Diseases of the circulatory (Cardiovascular) system, takotsubo syndrome, Registries, Original Research Article, 030212 general & internal medicine, Survival analysis, Outcome, Takotsubo syndrome, intertak registry, business.industry, InterTAK Registry, Incidence (epidemiology), Cardiogenic shock, Chronic obstructive pulmonary disease, Hazard ratio, broken heart syndrome, Shock, Cardiogenic, Prognosis, medicine.disease, Survival Analysis, outcome, Confidence interval, 3. Good health, RC666-701, Heart failure, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Cardiology and Cardiovascular Medicine, business
Abstract: © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License., Aims: Acute pulmonary disorders are known physical triggers of takotsubo syndrome (TTS). This study aimed to investigate prevalence of acute pulmonary triggers in patients with TTS and their impact on outcomes. Methods and results: Patients with TTS were enrolled from the International Takotsubo Registry and screened for triggering factors and comorbidities. Patients were categorized into three groups (acute pulmonary trigger, chronic lung disease, and no lung disease) to compare clinical characteristics and outcomes. Of the 1670 included patients with TTS, 123 (7%) were identified with an acute pulmonary trigger, and 194 (12%) had a known history of chronic lung disease. The incidence of cardiogenic shock was highest in patients with an acute pulmonary trigger compared with those with chronic lung disease or without lung disease (17% vs. 10% vs. 9%, P = 0.017). In-hospital mortality was also higher in patients with an acute pulmonary trigger than in the other two groups, although not significantly (5.7% vs. 1.5% vs. 4.2%, P = 0.13). Survival analysis demonstrated that patients with an acute pulmonary trigger had the worst long-term outcome (P = 0.002). The presence of an acute pulmonary trigger was independently associated with worse long-term mortality (hazard ratio 2.12, 95% confidence interval 1.33-3.38; P = 0.002). Conclusions: The present study demonstrates that TTS is related to acute pulmonary triggers in 7% of all TTS patients, which accounts for 21% of patients with physical triggers. The presence of acute pulmonary trigger is associated with a severe in-hospital course and a worse long-term outcome., C. T. has been supported by the H.H. Sheikh Khalifa binHamad Al-Thani Research Programme and the Swiss HeartFoundation. The InterTAK Registry is supported by the BissDavies Charitable Trust. L. S. M. has been supported by EUHORIZON 2020(SILICOFCM ID777204)
Published: 2021

18. Long-Term Prognosis of Patients With Takotsubo Syndrome

Author: John D. Horowitz, Thomas Münzel, David E. Winchester, Guido Michels, Katharina J. Ding, Wolfgang Koenig, Jeroen J. Bax, Burkert Pieske, Mahir Karakas, Christian Ukena, K.E. Juhani Airaksinen, Christoph Kaiser, Sebastiano Gili, Stephan B. Felix, Rafal Dworakowski, Christian Templin, Claudius Jacobshagen, Abhiram Prasad, Fabrizio D'Ascenzo, Lawrence Rajan, Martin Borggrefe, Rena A. Levinson, Christof Burgdorf, Florim Cuculi, Petr Tousek, Thomas F. Lüscher, Alexandra Shilova, Mikhail Gilyarov, Victoria L. Cammann, Roman Pfister, Frank Ruschitzka, Alessandro Candreva, Filippo Crea, Davide Di Vece, Wolfgang Rottbauer, Ruediger C. Braun-Dullaeus, Heribert Schunkert, Carsten Tschöpe, Stefan Osswald, Rodolfo Citro, Burkhardt Seifert, Annahita Sarcon, Ibrahim Akin, Gerd Hasenfuß, Leonarda Galiuto, L. Christian Napp, Holger Thiele, Ekaterina Gilyarova, Grzegorz Opolski, Susanne Heiner, Michel Noutsias, Johann Bauersachs, Miłosz Jaguszewski, Alessandro Cuneo, Hugo A. Katus, Olivier Lairez, Ibrahim El-Battrawy, Wolfgang Dichtl, Jozef Micek, Philip MacCarthy, Rahel Bianchi, Maike Knorr, Ken Kato, Adrian P. Banning, Jelena-R. Ghadri, Martin Kozel, Michael Böhm, Konrad A. Szawan, Jennifer Franke, Manfred Wischnewsky, Klaus Empen, Tuija Vasankari, Eduardo Bossone, Richard Kobza, Beatrice Bacchi, Susanne A. Schlossbauer, Petr Widimský, Stjepan Jurisic, Samir M. Said, Thomas Fischer, Clément Delmas, Ghadri, Jr, Kato, K, Cammann, Vl, Gili, S, Jurisic, S, Di Vece, D, Candreva, A, Ding, Kj, Micek, J, Szawan, Ka, Bacchi, B, Bianchi, R, Levinson, Ra, Wischnewsky, M, Seifert, B, Schlossbauer, Sa, Citro, R, Bossone, E, Munzel, T, Knorr, M, Heiner, S, D'Ascenzo, F, Franke, J, Sarcon, A, Napp, Lc, Jaguszewski, M, Noutsias, M, Katus, Ha, Burgdorf, C, Schunkert, H, Thiele, H, Bauersachs, J, Tschope, C, Pieske, Bm, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Hasenfuss, G, Karakas, M, Koenig, W, Rottbauer, W, Said, Sm, Braun-Dullaeus, Rc, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kej, Opolski, G, Dworakowski, R, Maccarthy, P, Kaiser, C, Osswald, S, Galiuto, L, Crea, F, Dichtl, W, Empen, K, Felix, Sb, Delmas, C, Lairez, O, El-Battrawy, I, Akin, I, Borggrefe, M, Horowitz, J, Kozel, M, Tousek, P, Widimsky, P, Gilyarova, E, Shilova, A, Gilyarov, M, Winchester, De, Ukena, C, Bax, Jj, Prasad, A, Bohm, M, Luscher, Tf, Ruschitzka, F, and Templin, C
Subjects: Male, Acute coronary syndrome, medicine.medical_specialty, Time Factors, 030204 cardiovascular system & hematology, tako tsubo syndrome, acute coronary syndrome, broken heart syndrome, classification, outcome, stress factor, Broken heart syndrome, 03 medical and health sciences, 0302 clinical medicine, Takotsubo Cardiomyopathy, Internal medicine, medicine, Humans, Registries, 030212 general & internal medicine, Mortality, Aged, Aged, 80 and over, Takotsubo syndrome, business.industry, Mortality rate, Electroencephalography, Emotional stress, Middle Aged, ta3121, Prognosis, Stress factor, medicine.disease, 3. Good health, Physical stress, Cardiology and Cardiovascular Medicine, Cohort, Female, Nervous System Diseases, business, Stress, Psychological, Follow-Up Studies
Abstract: Background Prognosis of Takotsubo syndrome (TTS) remains controversial due to scarcity of available data. Additionally, the effect of the triggering factors remains elusive. Objectives This study compared prognosis between TTS and acute coronary syndrome (ACS) patients and investigated short- and long-term outcomes in TTS based on different triggers. Methods Patients with TTS were enrolled from the International Takotsubo Registry. Long-term mortality of patients with TTS was compared to an age- and sex-matched cohort of patients with ACS. In addition, short- and long-term outcomes were compared between different groups according to triggering conditions. Results Overall, TTS patients had a comparable long-term mortality risk with ACS patients. Of 1,613 TTS patients, an emotional trigger was detected in 485 patients (30%). Of 630 patients (39%) related to physical triggers, 98 patients (6%) had acute neurologic disorders, while in the other 532 patients (33%), physical activities, medical conditions, or procedures were the triggering conditions. The remaining 498 patients (31%) had no identifiable trigger. TTS patients related to physical stress showed higher mortality rates than ACS patients during long-term follow-up, whereas patients related to emotional stress had better outcomes compared with ACS patients. Conclusions Overall, TTS patients had long-term outcomes comparable to age- and sex-matched ACS patients. Also, we demonstrated that TTS can either be benign or a life-threating condition depending on the inciting stress factor. We propose a new classification based on triggers, which can serve as a clinical tool to predict short- and long-term outcomes of TTS. (International Takotsubo Registry [InterTAK Registry]; NCT01947621)
Published: 2018

19. Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry

Author: Christian Templin, Antonio H. Frangieh, John D. Horowitz, Rodolfo Citro, Johann Bauersachs, Petr Widimský, Philip MacCarthy, David E. Winchester, Andrea Saglietto, Alessandro Cuneo, Guido Michels, Ekaterina Gilyarova, Burkert Pieske, Christian Ukena, Frank Ruschitzka, Christoph Kaiser, Mauro Gasparini, Mario Iannaccone, Wolfgang Koenig, Eduardo Bossone, Gaetano M. De Ferrari, Miłosz Jaguszewski, Florim Cuculi, Jeroen J. Bax, Wolfgang-Michael Franz, Leonarda Galiuto, L. Christian Napp, Grzegorz Opolski, Holger Thiele, Susanne Heiner, Abhiram Prasad, Carlo Di Mario, Stephan B. Felix, Thomas Münzel, Margherita Annaratone, Roman Pfister, Thomas F. Lüscher, Adrian P. Banning, Ruediger C. Braun-Dullaeus, Konrad A. Szawan, K.E. Juhani Airaksinen, Mahir Karakas, Michael Böhm, Victoria L. Cammann, Gerd Hasenfuß, Wolfgang Rottbauer, Rena A. Levinson, Samir M. Said, Ibrahim Akin, Fabrizio D'Ascenzo, Lawrence Rajan, Maike Knorr, Thomas Fischer, Rafal Dworakowski, Mikhail Gilyarov, Maurizio Bertaina, Annahita Sarcon, Mauro Rinaldi, Ken Kato, Martin Kozel, Wolfgang Dichtl, Carsten Tschöpe, Hugo A. Katus, Filippo Crea, Clément Delmas, Jennifer Franke, Giuseppe Biondi-Zoccai, Claudius Jacobshagen, Ibrahim El-Battrawy, Alexandra Shilova, Sebastiano Gili, Davide Di Vece, Beatrice Boffini, Michael Neuhaus, Christof Burgdorf, Petr Tousek, Jelena R. Ghadri, Martin Borggrefe, Stefan Osswald, Olivier Lairez, Richard Kobza, Heribert Schunkert, Klaus Empen, Tuija Vasankari, Michel Noutsias, D'Ascenzo, F., Gili, S., Bertaina, M., Iannaccone, M., Cammann, V. L., Di Vece, D., Kato, K., Saglietto, A., Szawan, K. A., Frangieh, A. H., Boffini, B., Annaratone, M., Sarcon, A., Levinson, R. A., Franke, J., Napp, L. C., Jaguszewski, M., Noutsias, M., Munzel, T., Knorr, M., Heiner, S., Katus, H. A., Burgdorf, C., Schunkert, H., Thiele, H., Bauersachs, J., Tschope, C., Pieske, B. M., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Hasenfuss, G., Karakas, M., Koenig, W., Rottbauer, W., Said, S. M., Braun-Dullaeus, R. C., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Opolski, G., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, L., Crea, F., Dichtl, W., Franz, W. M., Empen, K., Felix, S. B., Delmas, C., Lairez, O., El-Battrawy, I., Akin, I., Borggrefe, M., Horowitz, J. D., Kozel, M., Tousek, P., Widimsky, P., Gilyarova, E., Shilova, A., Gilyarov, M., Biondi-Zoccai, G., Winchester, D. E., Ukena, C., Neuhaus, M., Bax, J. J., Prasad, A., Di Mario, C., Bohm, M., Gasparini, M., Ruschitzka, F., Bossone, E., Citro, R., Rinaldi, M., De Ferrari, G. M., Luscher, T., Ghadri, J. R., and Templin, C.
Subjects: medicine.medical_specialty, Medical therapy, Acute heart failure, Aspirin, Outcome, Takotsubo syndrome, Myocardial Infarction, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Recurrence, Takotsubo Cardiomyopathy, law, Internal medicine, medicine, Humans, Registries, Myocardial infarction, Propensity Score, Stroke, Heart Failure, business.industry, Hazard ratio, medicine.disease, Confidence interval, 3. Good health, Treatment Outcome, Ischemic Attack, Transient, Heart failure, Propensity score matching, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Cardiology, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract: Aims The aim of the present study was to investigate the impact of aspirin on prognosis in takotsubo syndrome (TTS). Methods and results Patients from the International Takotsubo (InterTAK) Registry were categorized into two groups based on aspirin prescription at discharge. A comparison of clinical outcomes between groups was performed using an adjusted analysis with propensity score (PS) stratification; results from the unadjusted analysis were also reported to note the effect of the PS adjustment. Major adverse cardiac and cerebrovascular events (MACCE: a composite of death, myocardial infarction, TTS recurrence, stroke or transient ischaemic attack) were assessed at 30-day and 5-year follow-up. A total of 1533 TTS patients with known status regarding aspirin prescription at discharge were included. According to the adjusted analysis based on PS stratification, aspirin was not associated with a lower hazard of MACCE at 30-day [hazard ratio (HR) 1.24, 95% confidence interval (CI) 0.50-3.04, P = 0.64] or 5-year follow-up (HR 1.11, 95% CI 0.78-1.58, P = 0.58). These results were confirmed by sensitivity analyses performed with alternative PS-based methods, i.e. covariate adjustment and inverse probability of treatment weighting. Conclusion In the present study, no association was found between aspirin use in TTS patients and a reduced risk of MACCE at 30-day and 5-year follow-up. These findings should be confirmed in adequately powered randomized controlled trials. ClinicalTrials.gov Identifier: NCT01947621.
Published: 2020

20. Intraventricular thrombus formation and embolism in Takotsubo syndrome insights from the international Takotsubo registry

Author: Alexandra Shilova, Davide Di Vece, Johann Bauersachs, Wolfgang Koenig, Michael Neuhaus, Rodolfo Citro, Jose David Arroja, Adrian P. Banning, Jennifer Franke, Charanjit S. Rihal, Abhiram Prasad, Carlo Di Mario, Michael Böhm, Carsten Tschöpe, Burkhardt Seifert, Filippo Crea, Christian Templin, David E. Winchester, Hugo A. Katus, Clément Delmas, Pedro Carrilho-Ferreira, Paul Bridgman, Petr Tousek, Guido Michels, Fausto J. Pinto, Sebastiano Gili, Jelena R. Ghadri, Petr Widimský, Burkert Pieske, Jeroen J. Bax, Christian Ukena, Christoph Kaiser, Wolfgang Dichtl, Christof Burgdorf, Philippe Meyer, Christina Chan, Gerd Hasenfuß, Philip MacCarthy, Mikhail Gilyarov, Leonarda Galiuto, Grzegorz Opolski, Susanne Heiner, Ruediger C. Braun-Dullaeus, Alexander Pott, Annahita Sarcon, Ekaterina Gilyarova, Michel Noutsias, Lawrence Rajan, Claudius Jacobshagen, Roman Pfister, Behrouz Kherad, John D. Horowitz, Martin Borggrefe, Mahir Karakas, Stefan Osswald, Victoria L. Cammann, Katharina J. Ding, Jan Galuszka, Wolfgang Rottbauer, Ibrahim El-Battrawy, Stephan B. Felix, Martin Kozel, Ibrahim Akin, Thomas F. Lüscher, Frank Ruschitzka, Thomas Fischer, Fabrizio D'Ascenzo, Rafal Dworakowski, Olivier Lairez, L. Christian Napp, Holger Thiele, Eduardo Bossone, Thomas Münzel, Claudio Bilato, Maike Knorr, K.E. Juhani Airaksinen, Florim Cuculi, Carla Paolini, Konrad A. Szawan, Richard Kobza, Alessandro Cuneo, Barbara E. Stähli, Heribert Schunkert, Miłosz Jaguszewski, Manfred Wischnewsky, Tuija Vasankari, Ding, Kj, Cammann, Vl, Szawan, Ka, Stähli, Be, Wischnewsky, M, Di Vece, D, Citro, R, Jaguszewski, M, Seifert, B, Sarcon, A, Knorr, M, Heiner, S, Gili, S, D'Ascenzo, F, Neuhaus, M, Napp, Lc, Franke, J, Noutsias, M, Burgdorf, C, Koenig, W, Kherad, B, Rajan L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Karakas, M, Pott, A, Meyer, P, Arroja, Jd, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kej, Paolini, C, Bilato, C, Carrilho-Ferreira, P, Opolski, G, Dworakowski, R, Maccarthy, P, Kaiser, C, Osswald, S, Galiuto, L, Dichtl, W, Chan, C, Bridgman, P, Delmas, C, Lairez, O, El-Battrawy, I, Akin, I, Gilyarova, E, Shilova, A, Gilyarov, M, Kozel, M, Tousek, P, Widimský, P, Winchester, De, Galuszka, J, Ukena, C, Horowitz, Jd, Di Mario, C, Prasad A, Rihal, C, Pinto, Fj, Crea, F, Borggrefe, M, Braun-Dullaeus, Rc, Rottbauer, W, Bauersachs, J, Katus, Ha, Hasenfuß, G, Tschöpe, C, Pieske, Bm, Thiele, H, Schunkert, H, Böhm, M, Felix, Sb, Münzel, T, Bax, Jj, Lüscher, Tf, Ruschitzka, F, Ghadri, Jr, Bossone, E, and Templin, C.
Subjects: Male, Coronary angiography, Time Factors, Radionuclide ventriculography, 030204 cardiovascular system & hematology, Coronary Angiography, Electrocardiography, 0302 clinical medicine, Risk Factors, Registries, 030212 general & internal medicine, Framingham Risk Score, medicine.diagnostic_test, Incidence, Incidence (epidemiology), Magnetic Resonance Imaging, 3. Good health, Europe, Survival Rate, Cine, thrombus, cardiovascular system, Cardiology, outcome, Female, Cardiology and Cardiovascular Medicine, Takotsubo syndrome, medicine.medical_specialty, Heart Diseases, Heart Ventricles, Magnetic Resonance Imaging, Cine, risk score, Risk Assessment, embolism, 03 medical and health sciences, Takotsubo Cardiomyopathy, Internal medicine, medicine, Humans, cardiovascular diseases, Thrombus, Radionuclide Ventriculography, Aged, business.industry, Australia, Thrombosis, medicine.disease, United States, Embolism, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, business, Follow-Up Studies
Abstract: Objective: Takotsubo syndrome (TTS) is characterized by acute left ventricular dysfunction, which can contribute to intraventricular thrombus and embolism. Still, prevalence and clinical impact of thrombus formation and embolic events on outcome of TTS patients remain unclear. This study aimed to investigate clinical features and outcomes of patients with and without intraventricular thrombus or embolism. Additionally, factors associated with thrombus formation or embolism, as well as predictors for mortality, were identified. Approach and Results: TTS patients enrolled in the International Takotsubo Registry at 28 centers in Australia, Europe, and the United States were dichotomized according to the occurrence/absence of intraventricular thrombus or embolism. Patients with intraventricular thrombus or embolism were defined as the ThrombEmb group. Of 1676 TTS patients, 56 (3.3%) patients developed intraventricular thrombus and/or embolism following TTS diagnosis (median time interval, 2.0 days [range, 0–38 days]). Patients in the ThrombEmb group had a different clinical profile including lower left ventricular ejection fraction, higher prevalence of the apical type, elevated levels of troponin and inflammatory markers, and higher prevalence of vascular disease. In a Firth bias-reduced penalized-likelihood logistic regression model apical type, left ventricular ejection fraction ≤30%, previous vascular disease, and a white blood cell count on admission >10×10 3 cells/μL emerged as independent predictors for thrombus formation or embolism. Conclusions: Intraventricular thrombus or embolism occur in 3.3% of patients in the acute phase of TTS. A simple risk score including clinical parameters associated with intraventricular thrombus formation or embolism identifies patients at increased risk. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT01947621.
Published: 2020

21. Clinical Predictors and Prognostic Impact of Recovery of Wall Motion Abnormalities in Takotsubo Syndrome: Results From the International Takotsubo Registry

Author: Alessandro Cuneo, Rodolfo Citro, Sebastiano Gili, Victoria L. Cammann, L. Christian Napp, Wolfgang Rottbauer, Heribert Schunkert, Alexandra Shilova, Roman Pfister, Holger Thiele, Ibrahim Akin, Annahita Sarcon, Christof Burgdorf, Wolfgang Dichtl, Wolfgang Koenig, Petr Widimský, Pedro Carrilho-Ferreira, Mikhail Gilyarov, Philip MacCarthy, Fabrizio D'Ascenzo, Jeroen J. Bax, Hugo A. Katus, Paul Bridgman, K.E. Juhani Airaksinen, Eduardo Bossone, Stefan Osswald, Yoshio Kobayashi, Jan Galuszka, Gregor Poglajen, John D. Horowitz, Thomas Fischer, Ruediger C. Braun-Dullaeus, Konrad A. Szawan, Abhiram Prasad, Carlo Di Mario, Fausto J. Pinto, Thomas Münzel, Jennifer Franke, Carla Paolini, Richard Kobza, Christina Chan, Daniel Beug, Olivier Lairez, Claudio Bilato, Mahir Karakas, Florim Cuculi, Gerd Hasenfuß, Lawrence Rajan, Tuija Vasankari, Philippe Meyer, David E. Winchester, Jelena R. Ghadri, Adrian P. Banning, Leonarda Galiuto, Guido Michels, Stjepan Jurisic, Michel Noutsias, Rafal Dworakowski, Grzegorz Opolski, Maike Knorr, Susanne Heiner, Behrouz Kherad, Christian Templin, Johann Bauersachs, Stephan B. Felix, Burkert Pieske, Frank Ruschitzka, Martin Borggrefe, Petr Tousek, Thomas F. Lüscher, Michael Böhm, Christian Ukena, Ken Kato, Christoph Kaiser, Martin Kozel, Filippo Crea, Ekaterina Gilyarova, Ibrahim El-Battrawy, Charanjit S. Rihal, Clément Delmas, Alexander Pott, Claudius Jacobshagen, Jose David Arroja, Carsten Tschöpe, Miłosz Jaguszewski, Repositório da Universidade de Lisboa, Jurisic, S, Gili, S, Cammann, Vl, Kato, K, Szawan, Ka, D'Ascenzo, F, Jaguszewski, M, Bossone, E, Citro, R, Sarcon, A, Napp, Lc, Franke, J, Noutsias, M, Knorr, M, Heiner, S, Burgdorf, C, Koenig, W, Pott, A, Kherad, B, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Karakas, M, Meyer, P, Arroja, Jd, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kej, Dworakowski, R, Kaiser, C, Osswald, S, Galiuto, L, Dichtl, W, Chan, C, Bridgman, P, Beug, D, Delmas, C, Lairez, O, Kozel, M, Tousek, P, Winchester, De, Gilyarova, E, Shilova, A, Gilyarov, M, El-Battrawy, I, Akin, I, Galuszka, J, Ukena, C, Poglajen, G, Paolini, C, Bilato, C, Carrilho-Ferreira, P, Pinto, Fj, Opolski, G, Maccarthy, P, Kobayashi, Y, Prasad, A, Rihal, C, Widimsky, P, Horowitz, Jd, Di Mario, C, Crea, F, Tschope, C, Pieske, Bm, Hasenfuss, G, Rottbauer, W, Braun-Dullaeus, Rc, Felix, Sb, Borggrefe, M, Thiele, H, Bauersachs, J, Katus, Ha, Schunkert, H, Munzel, T, Bohm, M, Bax, Jj, Luscher, Tf, Ruschitzka, F, Ghadri, Jr, and Templin, C
Subjects: Male, medicine.medical_specialty, Time Factors, outcome, recovery, takotsubo syndrome, wall motion abnormalities, MEDLINE, 030204 cardiovascular system & hematology, Wall motion abnormalities, 03 medical and health sciences, 0302 clinical medicine, Takotsubo Cardiomyopathy, Recovery, Medicine, Humans, 030212 general & internal medicine, Wall motion, Prospective Studies, Registries, Intensive care medicine, Aged, Retrospective Studies, Original Research, Outcome, Heart Failure, Takotsubo syndrome, business.industry, Creative commons, Recovery of Function, Middle Aged, Prognosis, 3. Good health, ddc, Female, Cardiology and Cardiovascular Medicine, business, Switzerland
Abstract: © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes., 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, Christian Templin was supported by the H.H. Sheikh Khalifa bin Hamad Al‐Thani Research Programme and the Swiss Heart Foundation. The InterTAK Registry is supported by the Biss Davies Charitable Trust.
Published: 2019

22. Coexistence and outcome of coronary artery disease in Takotsubo syndrome

Author: Jelena R. Ghadri, Pedro Carrilho-Ferreira, Wolfgang Koenig, Carla Paolini, Adrian P. Banning, Alessandro Cuneo, Jeroen J. Bax, Petr Widimský, Manfred Wischnewsky, Yoichi Imori, Hugo A. Katus, Paul Bridgman, Martin Borggrefe, Tuija Vasankari, David E. Winchester, Annahita Sarcon, Abhiram Prasad, Alexander Pott, Claudius Jacobshagen, Sebastiano Gili, John D. Horowitz, Heribert Schunkert, Frank Ruschitzka, Stephan B. Felix, Michael Böhm, Guido Michels, Lars S. Maier, Fausto J. Pinto, Carlo Di Mario, Ruediger C. Braun-Dullaeus, Thomas F. Lüscher, Philippe Meyer, Lawrence Rajan, Burkert Pieske, Thomas Münzel, Stefan Osswald, Gerd Hasenfuß, Rodolfo Citro, Olivier Lairez, Mahir Karakas, Florim Cuculi, Christian Ukena, Victoria L. Cammann, Alexandra Shilova, Jose David Arroja, Leonarda Galiuto, Grzegorz Opolski, Christoph Kaiser, Wolfgang Rottbauer, Christian Templin, Carsten Tschöpe, Ibrahim Akin, Ioana Sorici-Barb, Susanne Heiner, Jennifer Franke, Fabrizio D'Ascenzo, Johann Bauersachs, Richard Kobza, Christof Burgdorf, Michael Neuhaus, P. Christian Schulze, Daniel Beug, Petr Tousek, Filippo Crea, Monika Budnik, Miłosz Jaguszewski, Roman Pfister, Konrad A. Szawan, Ekaterina Gilyarova, Philip MacCarthy, Wolfgang Dichtl, Yoshio Kobayashi, Jan Galuszka, Michel Noutsias, Christina Chan, Thomas Fischer, Matteo Bianco, Ibrahim El-Battrawy, L. Christian Napp, Holger Thiele, Karolina Polednikova, Claudio Bilato, Charanjit S. Rihal, Clément Delmas, Rafal Dworakowski, Mikhail Gilyarov, Eduardo Bossone, Gregor Poglajen, Behrouz Kherad, Ken Kato, Christian Hauck, Maike Knorr, Eugene Braunwald, K.E. Juhani Airaksinen, Christian Napp, L., Cammann, V. L., Jaguszewski, M., Szawan, K. A., Wischnewsky, M., Gili, S., Knorr, M., Heiner, S., Citro, R., Bossone, E., D'Ascenzo, F., Neuhaus, M., Franke, J., Sorici-Barb, I., Noutsias, M., Burgdorf, C., Koenig, W., Kherad, B., Sarcon, A., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Pott, A., Meyer, P., Arroja, J. D., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Juhani Airaksinen, K. E., Hauck, C., Paolini, C., Bilato, C., Imori, Y., Kato, K., Kobayashi, Y., Opolski, G., Budnik, M., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, L., Dichtl, W., Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., El-Battrawy, I., Akin, I., Gilyarova, E., Shilova, A., Gilyarov, M., Horowitz, J. D., Polednikova, K., Tousek, P., Widimsky, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Mario, C. D., Prasad, A., Rihal, C. S., Christian Schulze, P., Bianco, M., Crea, F., Borggrefe, M., Maier, L. S., Pinto, F. J., Braun-Dullaeus, R. C., Rottbauer, W., Katus, H. A., Hasenfuss, G., Tschope, C., Pieske, B. M., Thiele, H., Schunkert, H., Bohm, M., Felix, S. B., Munzel, T., Bax, J. J., Bauersachs, J., Braunwald, E., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Templin, C., and Repositório da Universidade de Lisboa
Subjects: medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Takotsubo Cardiomyopathy, Internal medicine, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, Acute Coronary Syndrome, 10. No inequality, Cardiac catheterization, Outcome, medicine.diagnostic_test, business.industry, Incidence, Percutaneous coronary intervention, medicine.disease, 3. Good health, Coronary occlusion, Heart failure, Angiography, Cardiology, Cardiology and Cardiovascular Medicine, business, Takotsubo syndrome
Abstract: Copyright © 2020 European Society of Cardiology, Aims: Takotsubo syndrome (TTS) is an acute heart failure syndrome, which shares many features with acute coronary syndrome (ACS). Although TTS was initially described with angiographically normal coronary arteries, smaller studies recently indicated a potential coexistence of coronary artery disease (CAD) in TTS patients. This study aimed to determine the coexistence, features, and prognostic role of CAD in a large cohort of patients with TTS. Methods and results: Coronary anatomy and CAD were studied in patients diagnosed with TTS. Inclusion criteria were compliance with the International Takotsubo Diagnostic Criteria for TTS, and availability of original coronary angiographies with ventriculography performed during the acute phase. Exclusion criteria were missing views, poor quality of angiography loops, and angiography without ventriculography. A total of 1016 TTS patients were studied. Of those, 23.0% had obstructive CAD, 41.2% had non-obstructive CAD, and 35.7% had angiographically normal coronary arteries. A total of 47 patients (4.6%) underwent percutaneous coronary intervention, and 3 patients had acute and 8 had chronic coronary artery occlusion concomitant with TTS, respectively. The presence of CAD was associated with increased incidence of shock, ventilation, and death from any cause. After adjusting for confounders, the presence of obstructive CAD was associated with mortality at 30 days. Takotsubo syndrome patients with obstructive CAD were at comparable risk for shock and death and nearly at twice the risk for ventilation compared to an age- and sex-matched ACS cohort. Conclusions: Coronary artery disease frequently coexists in TTS patients, presents with the whole spectrum of coronary pathology including acute coronary occlusion, and is associated with adverse outcome.
Published: 2019

23. Clinical Features and Outcomes of Patients With Malignancy and Takotsubo Syndrome: Observations From the International Takotsubo Registry

Author: Petr Widimský, Katharina J. Ding, Sebastiano Gili, L. Christian Napp, Holger Thiele, Stephan B. Felix, Christof Burgdorf, Thomas F. Lüscher, Johann Bauersachs, Mahir Karakas, Alexandra Shilova, Davide Di Vece, Gerd Hasenfuß, Miłosz Jaguszewski, Roman Pfister, Thomas Münzel, Hugo A. Katus, David E. Winchester, Stefan Osswald, Thomas Fischer, Guido Michels, Ruediger C. Braun-Dullaeus, Adrian P. Banning, Philip MacCarthy, Stjepan Jurisic, Burkert Pieske, Christian Ukena, Fabrizio D'Ascenzo, Christoph Kaiser, Michael Böhm, Olivier Lairez, Rodolfo Citro, Richard Kobza, Antonio H. Frangieh, John D. Horowitz, Leonarda Galiuto, Grzegorz Opolski, Susanne Heiner, Filippo Crea, Beatrice Bacchi, Annahita Sarcon, Jeroen J. Bax, Wolfgang Dichtl, Victoria L. Cammann, Jelena R. Ghadri, Ekaterina Gilyarova, Wolfgang Rottbauer, Frank Ruschitzka, Ibrahim Akin, Ibrahim El-Battrawy, Martin Borggrefe, Jozef Micek, Clément Delmas, Lawrence Rajan, Rafal Dworakowski, Mikhail Gilyarov, Christian Templin, Petr Tousek, Jerold S. Shinbane, Tuija Vasankari, Michel Noutsias, Heribert Schunkert, Wolfgang Koenig, Eduardo Bossone, Abhiram Prasad, Carlo Di Mario, Alessandro Cuneo, Ken Kato, Martin Kozel, Konrad A. Szawan, Florim Cuculi, Maike Knorr, K.E. Juhani Airaksinen, Jennifer Franke, Carsten Tschöpe, Burkhardt Seifert, Claudius Jacobshagen, Cammann, Vl, Sarcon, A, Ding, Kj, Seifert, B, Kato, K, Di Vece, D, Szawan, Ka, Gili, S, Jurisic, S, Bacchi, B, Micek, J, Frangieh, Ah, Napp, Lc, Jaguszewski, M, Bossone, E, Citro, R, D'Ascenzo, F, Franke, J, Noutsias, M, Knorr, M, Heiner, S, Burgdorf, C, Koenig, W, Thiele, H, Tschope, C, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Karakas, M, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kej, Dworakowski, R, Kaiser, C, Osswald, S, Galiuto, L, Dichtl, W, Delmas, C, Lairez, O, Horowitz, Jd, Kozel, M, Widimsky, P, Tousek, P, Winchester, De, Gilyarova, E, Shilova, A, Gilyarov, M, El-Battrawy, I, Akin, I, Ukena, C, Bauersachs, J, Pieske, Bm, Hasenfuss, G, Rottbauer, W, Braun-Dullaeus, Rc, Opolski, G, Maccarthy, P, Felix, Sb, Borggrefe, M, Di Mario, C, Crea, F, Katus, Ha, Schunkert, H, Munzel, T, Bohm, M, Bax, Jj, Prasad, A, Shinbane, J, Luscher, Tf, Ruschitzka, F, Ghadri, Jr, and Templin, C
Subjects: medicine.medical_specialty, Acute coronary syndrome, acute coronary syndrome, broken heart syndrome, cancer, malignancy, outcome, takotsubo syndrome, 030204 cardiovascular system & hematology, Malignancy, Broken heart syndrome, 03 medical and health sciences, 0302 clinical medicine, Takotsubo Cardiomyopathy, Neoplasms, Internal medicine, medicine, Humans, In patient, Registries, 030212 general & internal medicine, Original Research, Heart Failure, Takotsubo syndrome, business.industry, Cancer, medicine.disease, ddc, 3. Good health, Clinical trial, Cohort, Cardiology and Cardiovascular Medicine, business
Abstract: Background Clinical characteristics and outcomes of takotsubo syndrome (TTS) patients with malignancy have not been fully elucidated. This study sought to explore differences in clinical characteristics and to investigate short‐ and long‐term outcomes in TTS patients with or without malignancy. Methods and Results TTS patients were enrolled from the International Takotsubo Registry. The TTS cohort was divided into patients with and without malignancy to investigate differences in clinical characteristics and to assess short‐ and long‐term mortality. A subanalysis was performed comparing long‐term mortality between a subset of TTS patients with or without malignancy and acute coronary syndrome (ACS) patients with or without malignancy. Malignancy was observed in 16.6% of 1604 TTS patients. Patients with malignancy were older and more likely to have physical triggers, but less likely to have emotional triggers compared with those without malignancy. Long‐term mortality was higher in patients with malignancy (P, See Editorial Angelini and Uribe
Published: 2019

24. Cardiac arrest in takotsubo syndrome: results from the InterTAK Registry

Author: David E. Winchester, Philip MacCarthy, Leonarda Galiuto, Guido Michels, Hugo A. Katus, Grzegorz Opolski, Susanne Heiner, Burkert Pieske, Christian Ukena, Wolfgang Koenig, Richard Kobza, Sebastiano Gili, Christoph Kaiser, Eduardo Bossone, Beatrice Bacchi, Johann Bauersachs, Filippo Crea, K.E. Juhani Airaksinen, Konrad A. Szawan, Heribert Schunkert, Abhiram Prasad, Carlo Di Mario, John D. Horowitz, L. Christian Napp, Holger Thiele, Gerd Hasenfuß, Rafal Dworakowski, Ekaterina Gilyarova, Roman Pfister, Christof Burgdorf, Christian Templin, Flurina Famos, Stjepan Jurisic, Victoria L. Cammann, Stefan Osswald, Miłosz Jaguszewski, Maike Knorr, Wolfgang Rottbauer, Alexandra Shilova, Ibrahim Akin, Petr Tousek, Jeroen J. Bax, Adrian P. Banning, Lawrence Rajan, Alessandro Cuneo, Davide Di Vece, Claudius Jacobshagen, Katharina J. Ding, Susanne A. Schlossbauer, Jennifer Franke, Ruediger C. Braun-Dullaeus, Manfred Wischnewsky, Klaus Empen, Michael Böhm, Carsten Tschöpe, Petr Widimský, Stephan B. Felix, Olivier Lairez, Burkhardt Seifert, Thomas Münzel, Michel Noutsias, Tuija Vasankari, Thomas F. Lüscher, Ibrahim El-Battrawy, Slayman Obeid, Fabrizio D'Ascenzo, Florim Cuculi, Mikhail Gilyarov, Rodolfo Citro, Mahir Karakas, Ken Kato, Jozef Micek, Fiorenzo Gaita, Martin Kozel, Wolfgang Dichtl, Clément Delmas, Rena A. Levinson, Samir M. Said, Olivia Lenoir, Annahita Sarcon, Thomas Fischer, Jelena R. Ghadri, Martin Borggrefe, Frank Ruschitzka, Gili, S, Cammann, Vl, Schlossbauer, Sa, Kato, K, D'Ascenzo, F, Di Vece, D, Jurisic, S, Micek, J, Obeid, S, Bacchi, B, Szawan, Ka, Famos, F, Sarcon, A, Levinson, R, Ding, Kj, Seifert, B, Lenoir, O, Bossone, E, Citro, R, Franke, J, Napp, Lc, Jaguszewski, M, Noutsias, M, Munzel, T, Knorr, M, Heiner, S, Katus, Ha, Burgdorf, C, Schunkert, H, Thiele, H, Bauersachs, J, Tschope, C, Pieske, Bm, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Hasenfuss, G, Karakas, M, Koenig, W, Rottbauer, W, Said, Sm, Braun-Dullaeus, Rc, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kej, Opolski, G, Dworakowski, R, Maccarthy, P, Kaiser, C, Osswald, S, Galiuto, L, Crea, F, Dichtl, W, Empen, K, Felix, Sb, Delmas, C, Lairez, O, El-Battrawy, I, Akin, I, Borggrefe, M, Gilyarova, E, Shilova, A, Gilyarov, M, Horowitz, Jd, Kozel, M, Tousek, P, Widimsky, P, Winchester, De, Ukena, C, Gaita, F, Di Mario, C, Wischnewsky, Mb, Bax, Jj, Prasad, A, Bohm, M, Ruschitzka, F, Luscher, Tf, Ghadri, Jr, and Templin, C
Subjects: Male, Tachycardia, Acute heart failure, Broken heart syndrome, Cardiac arrest, Outcome, Takotsubo syndrome, medicine.medical_specialty, Cardiomyopathy, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Clinical Research, Takotsubo Cardiomyopathy, Internal medicine, Humans, Medicine, Registries, 030212 general & internal medicine, Asystole, Retrospective Studies, Ejection fraction, business.industry, Atrial fibrillation, Middle Aged, Prognosis, medicine.disease, Survival Analysis, ddc, Heart Arrest, 3. Good health, Editor's Choice, Editorial, Pulseless electrical activity, Ventricular fibrillation, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Aims We aimed to evaluate the frequency, clinical features, and prognostic implications of cardiac arrest (CA) in takotsubo syndrome (TTS). Methods and results We reviewed the records of patients with CA and known heart rhythm from the International Takotsubo Registry. The main outcomes were 60-day and 5-year mortality. In addition, predictors of mortality and predictors of CA during the acute TTS phase were assessed. Of 2098 patients, 103 patients with CA and known heart rhythm during CA were included. Compared with patients without CA, CA patients were more likely to be younger, male, and have apical TTS, atrial fibrillation (AF), neurologic comorbidities, physical triggers, and longer corrected QT-interval and lower left ventricular ejection fraction on admission. In all, 57.1% of patients with CA at admission had ventricular fibrillation/tachycardia, while 73.7% of patients with CA in the acute phase had asystole/pulseless electrical activity. Patients with CA showed higher 60-day (40.3% vs. 4.0%, P Conclusions Cardiac arrest is relatively frequent in TTS and is associated with higher short- and long-term mortality. Clinical and electrocardiographic parameters independently predicted mortality after CA.
Published: 2019

25. Outcomes Associated With Cardiogenic Shock in Takotsubo Syndrome: Results From the International Takotsubo Registry

Author: Roman Pfister, Florim Cuculi, Stefan Osswald, Michel Noutsias, Klaus Empen, Annahita Sarcon, Philip MacCarthy, Alessandro Cuneo, Tuija Vasankari, Ruediger C. Braun-Dullaeus, Alessandro Candreva, Rodolfo Citro, Mahir Karakas, Katharina J. Ding, Christian Templin, Wolfgang Koenig, Petr Tousek, L. Christian Napp, Fabrizio D'Ascenzo, Petr Widimský, Samir M. Said, Richard Kobza, Olivier Lairez, Holger Thiele, K.E. Juhani Airaksinen, Beatrice Bacchi, Abhiram Prasad, Carlo Di Mario, David E. Winchester, Eduardo Bossone, Filippo Crea, Claudius Jacobshagen, Heribert Schunkert, Guido Michels, Alexandra Shilova, Sebastiano Gili, Jozef Micek, Ekaterina Gilyarova, Konrad A. Szawan, Davide Di Vece, Burkert Pieske, Carsten Tschöpe, Thomas Fischer, Thomas Münzel, Christian Ukena, Christoph Kaiser, Adrian P. Banning, Stephan B. Felix, Jennifer Franke, John D. Horowitz, Thomas F. Lüscher, Hugo A. Katus, Jelena-R. Ghadri, Christof Burgdorf, Ken Kato, Martin Borggrefe, Michael Böhm, Miłosz Jaguszewski, Martin Kozel, Frank Ruschitzka, Maike Knorr, Victoria L. Cammann, Ibrahim El-Battrawy, Wolfgang Rottbauer, Moritz Schwyzer, Stjepan Jurisic, Ibrahim Akin, Clément Delmas, Mikhail Gilyarov, Jeroen J. Bax, Leonarda Galiuto, Grzegorz Opolski, Susanne Heiner, Johann Bauersachs, Gerd Hasenfuβ, Rafal Dworakowski, Lawrence Rajan, Wolfgang Dichtl, Di Vece, D, Citro, R, Cammann, Vl, Kato, K, Gili, S, Szawan, Ka, Micek, J, Jurisic, S, Ding, Kj, Bacchi, B, Schwyzer, M, Candreva, A, Bossone, E, D'Ascenzo, F, Sarcon, A, Franke, J, Napp, Lc, Jaguszewski, M, Noutsias, M, Munzel, T, Knorr, M, Heiner, S, Katus, Ha, Burgdorf, C, Schunkert, H, Thiele, H, Bauersachs, J, Tschope, C, Pieske, Bm, Rajan, L, Michels, G, Pfister, R, Cuneo, A, Jacobshagen, C, Hasenfuss, G, Karakas, M, Koenig, W, Rottbauer, W, Said, Sm, Braun-Dullaeus, Rc, Banning, A, Cuculi, F, Kobza, R, Fischer, Ta, Vasankari, T, Airaksinen, Kj, Opolski, G, Dworakowski, R, Maccarthy, P, Kaiser, C, Osswald, S, Galiuto, L, Crea, F, Dichtl, W, Empen, K, Felix, Sb, Delmas, C, Lairez, O, El-Battrawy, I, Akin, I, Borggrefe, M, Gilyarova, E, Shilova, A, Gilyarov, M, Horowitz, J, Kozel, M, Tousek, P, Widimsky, P, Winchester, De, Ukena, C, Di Mario, C, Prasad, A, Bohm, M, Bax, Jj, Luscher, Tf, Ruschitzka, F, Ghadri, Jr, and Templin, C
Subjects: Male, medicine.medical_specialty, Time Factors, Comorbidity, 030204 cardiovascular system & hematology, Risk Assessment, Broken heart syndrome, 03 medical and health sciences, 0302 clinical medicine, Informed consent, Risk Factors, Takotsubo Cardiomyopathy, Physiology (medical), cardiac mechanical support, Medicine, Humans, takotsubo syndrome, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Registries, broken heart syndrome, cardiogenic shock, outcome, Aged, Female, Middle Aged, Prognosis, Retrospective Studies, Shock, Cardiogenic, Takotsubo syndrome, business.industry, Cardiogenic shock, Incidence (epidemiology), Medical record, Ethics committee, Shock, ta3121, medicine.disease, Cardiogenic, 3. Good health, Emergency medicine, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Observational study, Cardiology and Cardiovascular Medicine, business
Abstract: The clinical course of takotsubo syndrome (TTS) can be complicated by several life-threatening conditions. In particular, cardiogenic shock (CS) represents one of the leading causes of mortality in the acute phase and occurs in a considerable number of patients with TTS, with an incidence of ≈10%. At present, no established guidelines are available to support specific treatment recommendations,and the conventional therapy for CS leads to uncertain results in TTS cases. The International Takotsubo Registry (www.takotsubo-registry.com) is an observational, prospective, and retrospective registry established at the University Hospital Zurich in 2011, with the largest TTS database worldwide. Patients were included in the registry between 2011 and 2017 based on modified Mayo Clinic Diagnostic criteria. Hospitalization data were recorded through standardized forms on admission or during revision of clinical charts; follow-up data were obtained from medical records, telephone follow-up, or clinical visits. The study population was categorized into 2 groups: patients with TTS with and without CS. The study protocol was reviewed by the respective local ethics committees or investigational review boards at each collaboration site. Where informed consent was required, formal written consent was obtained from patients.
Published: 2019

26. Functional variants of the HMGA1 gene and type 2 diabetes mellitus

Author: Chiefari E, Tanyolaç S, Paonessa F, Pullinger CR, Capula C, Iiritano S, Mazza T, Forlin M, Fusco A, Durlach V, Durlach A, Malloy MJ, Kane JP, Heiner SW, Filocamo M, Foti DP, Goldfine ID, Brunetti A., Matrice extracellulaire et dynamique cellulaire - UMR 7369 (MEDyC), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS), Chiefari, E., Tanyolaç, S., Paonessa, F., Pullinger, C. R., Capula, C., Iiritano, S., Mazza, T., Forlin, M., Fusco, Alfredo, Durlach, V., Durlach, A., Malloy, M. J., Kane, J. P., Heiner, S. W., Filocamo, M., Foti, D. P., Goldfine, I. D., and Brunetti, A.
Subjects: GENE EXPRESSION, RECEPTOR, DIABETES MELLITUS, GENETIC PREDISPOSITION TO DISEASE, TYPE 2, HMGA PROTEINS, EUROPEAN CONTINENTAL ANCESTRY GROUP, INSULIN, ComputingMilieux_MISCELLANEOUS, INSULIN RESISTANCE
Abstract: CONTEXT: High-mobility group A1 (HMGA1) protein is a key regulator of insulin receptor (INSR) gene expression. We previously identified a functional HMGA1 gene variant in 2 insulin-resistant patients with decreased INSR expression and type 2 diabetes mellitus (DM). OBJECTIVE: To examine the association of HMGA1 gene variants with type 2 DM. DESIGN, SETTINGS, AND PARTICIPANTS: Case-control study that analyzed the HMGA1 gene in patients with type 2 DM and controls from 3 populations of white European ancestry. Italian patients with type 2 DM (n = 3278) and 2 groups of controls (n = 3328) were attending the University of Catanzaro outpatient clinics and other health care sites in Calabria, Italy, during 2003-2009; US patients with type 2 DM (n = 970) were recruited in Northern California clinics between 1994 and 2005 and controls (n = 958) were senior athletes without DM collected in 2004 and 2009; and French patients with type 2 DM (n = 354) and healthy controls (n = 50) were enrolled at the University of Reims in 1992. Genomic DNA was either directly sequenced or analyzed for specific HMGA1 mutations. Messenger RNA and protein expression for HMGA1 and INSR were measured in both peripheral lymphomonocytes and cultured Epstein-Barr virus-transformed lymphoblasts from patients with type 2 DM and controls. MAIN OUTCOME MEASURES: The frequency of HMGA1 gene variants among cases and controls. Odds ratios (ORs) for type 2 DM were estimated by logistic regression analysis. RESULTS: The most frequent functional HMGA1 variant, IVS5-13insC, was present in 7% to 8% of patients with type 2 DM in all 3 populations. The prevalence of IVS5-13insC variant was higher among patients with type 2 DM than among controls in the Italian population (7.23% vs 0.43% in one control group; OR, 15.77 [95% confidence interval {CI}, 8.57-29.03]; P < .001 and 7.23% vs 3.32% in the other control group; OR, 2.03 [95% CI, 1.51-3.43]; P < .001). In the US population, the prevalence of IVS5-13insC variant was 7.7% among patients with type 2 DM vs 4.7% among controls (OR, 1.64 [95% CI, 1.05-2.57]; P = .03). In the French population, the prevalence of IVS5-13insC variant was 7.6% among patients with type 2 DM and 0% among controls (P = .046). In the Italian population, 3 other functional variants were observed. When all 4 variants were analyzed, HMGA1 defects were present in 9.8% of Italian patients with type 2 DM and 0.6% of controls. In addition to the IVS5 C-insertion, the c.310G>T (p.E104X) variant was found in 14 patients and no controls (Bonferroni-adjusted P = .01); the c.*82G>A variant (rs2780219) was found in 46 patients and 5 controls (Bonferroni-adjusted P < .001); the c.*369del variant was found in 24 patients and no controls (Bonferroni-adjusted P < .001). In circulating monocytes and Epstein-Barr virus-transformed lymphoblasts from patients with type 2 DM and the IVS5-13insC variant, the messenger RNA levels and protein content of both HMGA1 and the INSR were decreased by 40% to 50%, and these defects were corrected by transfection with HMGA1 complementary DNA. CONCLUSIONS: Compared with healthy controls, the presence of functional HMGA1 gene variants in individuals of white European ancestry was associated with type 2 DM.
Published: 2011

27. Age -Related Variations in Takotsubo Syndrome

Author: Behrouz Kherad, Roman Pfister, Ken Kato, Stefan Osswald, Thanh H Nguyen, Benjamin Meder, Alessandro Cuneo, Toshiharu Himi, Stephan B. Felix, Marco Roffi, Lawrence Rajan, Thomas F. Lüscher, David E. Winchester, Sebastiano Gili, Gerd Hasenfuß, Guido Michels, Ibrahim El-Battrawy, Petr Widimský, Olivier Lairez, Victoria L. Cammann, Rafal Dworakowski, Eduardo Bossone, Mahir Karakas, Charanjit S. Rihal, Burkert Pieske, Barbara E. Stähli, Gregor Poglajen, Wolfgang Rottbauer, Leonarda Galiuto, Grzegorz Opolski, Christian Ukena, Susanne Heiner, Christoph Kaiser, Christian Hauck, Filippo Crea, Wolfgang Koenig, Ibrahim Akin, Christof Burgdorf, Carsten Tschöpe, Clément Delmas, Yoshio Kobayashi, K.E. Juhani Airaksinen, Florim Cuculi, Mikhail Gilyarov, Pedro Carrilho-Ferreira, Masayuki Takahara, Ali Al-Shammari, Christina Chan, Jerold S. Shinbane, Miłosz Jaguszewski, Hugo A. Katus, Fabrizio D'Ascenzo, Wolfgang Dichtl, Jehangir Din, Paul Bridgman, John D. Horowitz, Toshihiro Shoji, Jan Galuszka, Monika Budnik, Claudio Bilato, Jelena R. Ghadri, Alexander Pott, Christian Templin, Konrad A. Szawan, Claudius Jacobshagen, Ruediger C. Braun-Dullaeus, Gonçalo Pestana, Abhiram Prasad, Carlo Di Mario, Fausto J. Pinto, Maike Knorr, Iwao Ishibashi, Thomas Münzel, Lars S. Maier, Jennifer Franke, Mathias Wolfrum, Adrian P. Banning, Philippe Meyer, Kan Liu, Alexandra Shilova, Davide Di Vece, Daniel Beug, Michael Neuhaus, Martin Borggrefe, Michael Böhm, Annahita Sarcon, Heribert Schunkert, Petr Tousek, Rena A. Levinson, Ekaterina Gilyarova, Frank Ruschitzka, Carla Paolini, Michel Noutsias, Richard Kobza, Thomas Fischer, Matteo Bianco, P. Christian Schulze, Lucas Jörg, Manfred Wischnewsky, Sara Dreiding, Hans Rickli, Tuija Vasankari, Rodolfo Citro, Jeroen J. Bax, Philip MacCarthy, L. Christian Napp, Holger Thiele, Karolina Polednikova, Johann Bauersachs, Repositório da Universidade de Lisboa, Cammann, V. L., Szawan, K. A., Stahli, B. E., Kato, K., Budnik, M., Wischnewsky, M., Dreiding, S., Levinson, R. A., Di Vece, D., Gili, S., Citro, R., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, F., Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Roffi, M., Banning, A., Wolfrum, M., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Napp, L. C., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, L., Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., El-Battrawy, I., Akin, I., Polednikova, K., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Kobayashi, Y., Shoji, T., Ishibashi, I., Takahara, M., Himi, T., Din, J., Al-Shammari, A., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Borggrefe, M., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, C., Munzel, T., Crea, F., Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Opolski, G., and Templin, C.
Subjects: Male, Pediatrics, medicine.medical_specialty, Shock, Cardiogenic, Hospital mortality, 030204 cardiovascular system & hematology, age, broken heart syndrome, outcome, takotsubo syndrome, Global Health, Risk Assessment, Broken heart syndrome, 03 medical and health sciences, 0302 clinical medicine, Age, Takotsubo Cardiomyopathy, Intensive care, Age related, Prevalence, Medicine, Humans, 030212 general & internal medicine, Registries, Hospital Mortality, Mortality, Age of Onset, Aged, Outcome, Takotsubo syndrome, business.industry, Mental Disorders, Age Factors, Shock, Middle Aged, medicine.disease, Prognosis, Cardiogenic, 3. Good health, Causality, Baseline characteristics, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Female, Age of onset, Nervous System Diseases, Cardiology and Cardiovascular Medicine, business
Abstract: © 2020 by the American College of Cardiology Foundation., BACKGROUND: Takotsubo syndrome (TTS) occurs predominantly in post-menopausal women but is also found in younger patients. OBJECTIVES: This study aimed to investigate age-related differences in TTS. METHODS: Patients diagnosed with TTS and enrolled in the International Takotsubo Registry between January 2011 and February 2017 were included in this analysis and were stratified by age (younger: #50 years, middle-age: 51 to 74 years, elderly: $75 years). Baseline characteristics, hospital course, as well as short- and long-term mortality were compared among groups. RESULTS Of 2,098 TTS patients, 242 (11.5%) patients were #50 years of age, 1,194 (56.9%) were 51 to 74 years of age, and 662 (31.6%) were $75 years of age. Younger patients were more often men (12.4% vs. 10.9% vs. 6.3%; p ¼ 0.002) and had an increased prevalence of acute neurological (16.3% vs. 8.4% vs. 8.8%; p ¼ 0.001) or psychiatric disorders (14.1% vs. 10.3% vs. 5.6%; p < 0.001) compared with middle-aged and elderly TTS patients. Furthermore, younger patients had more often cardiogenic shock (15.3% vs. 9.1% vs. 8.1%; p ¼ 0.004) and had a numerically higher in-hospital mortality (6.6% vs. 3.6% vs. 5.1%; p ¼ 0.07). At multivariable analysis, younger (odds ratio: 1.60; 95% confidence interval: 0.86 to 3.01; p ¼ 0.14) and older age (odds ratio: 1.09; 95% confidence interval: 0.66 to 1.80; p ¼ 0.75) were not independently associated with in-hospital mortality using the middle-aged group as a reference. There were no differences in 60-day mortality rates among groups. CONCLUSIONS: A substantial proportion of TTS patients are younger than 50 years of age. TTS is associated with severe complications requiring intensive care, particularly in younger patients.

28. Changes in authoritarianism before and during the COVID-19 pandemic: Comparisons of latent means across East and West Germany, gender, age, and education.

Author: Heller A, Decker O, Clemens V, Fegert JM, Heiner S, Brähler E, and Schmidt P
Abstract: Modern theories of authoritarianism have stressed the importance of threat to the expression of authoritarian attitudes and intolerance. Arguably, authoritarian tendencies may have increased during COVID-19 pandemic, a major threat to life and security. One issue arising when comparing mean scores is that of measurement invariance. Meaningful comparisons are only possible, if latent constructs are similar between groups and/or across time. This prerequisite is rarely ever tested in research on authoritarianism. In this study, we aim to analyze the short scale for authoritarianism KSA-3 by investigating its measurement invariance on two levels (three first-order and one second-order factors) and latent mean changes using two German representative samples ( N = 4,905). Specifically, we look at differences before and during the pandemic (2017 vs. 2020). While measurement invariance holds across both levels in all conditions, we find a decrease in latent means in 2020, contrary to expectations and established theories. Moreover, latent means differ with regard to gender, education, and east-west Germany. We conclude that analyses of latent means and measurement invariance instead of mean comparisons with composites should become the standard. Future studies should focus on threat as a moderator between authoritarianism and intolerance, and on possible interactions with context variables., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Heller, Decker, Clemens, Fegert, Heiner, Brähler and Schmidt.)
Published: 2022
Full Text: View/download PDF

29. Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry.

Author: Imori Y, Kato K, Cammann VL, Szawan KA, Wischnewsky M, Dreiding S, Würdinger M, Schönberger M, Petkova V, Niederseer D, Levinson RA, Di Vece D, Gili S, Seifert B, Wakita M, Suzuki N, Citro R, Bossone E, Heiner S, Knorr M, Jansen T, Münzel T, D'Ascenzo F, Franke J, Sorici-Barb I, Katus HA, Sarcon A, Shinbane J, Napp LC, Bauersachs J, Jaguszewski M, Shiomura R, Nakamura S, Takano H, Noutsias M, Burgdorf C, Ishibashi I, Himi T, Koenig W, Schunkert H, Thiele H, Kherad B, Tschöpe C, Pieske BM, Rajan L, Michels G, Pfister R, Mizuno S, Cuneo A, Jacobshagen C, Hasenfuß G, Karakas M, Mochizuki H, Pott A, Rottbauer W, Said SM, Braun-Dullaeus RC, Banning A, Isogai T, Kimura A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Tomita Y, Budnik M, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Murakami T, Ikari Y, Empen K, Beug D, Felix SB, Delmas C, Lairez O, Yamaguchi T, El-Battrawy I, Akin I, Borggrefe M, Horowitz JD, Kozel M, Tousek P, Widimský P, Gilyarova E, Shilova A, Gilyarov M, Neuhaus M, Meyer P, Arroja JD, Chan C, Bridgman P, Galuszka J, Poglajen G, Carrilho-Ferreira P, Pinto FJ, Hauck C, Maier LS, Liu K, Di Mario C, Paolini C, Bilato C, Bianco M, Jörg L, Rickli H, Winchester DE, Ukena C, Böhm M, Bax JJ, Prasad A, Rihal CS, Saito S, Kobayashi Y, Lüscher TF, Ruschitzka F, Shimizu W, Ghadri JR, and Templin C
Subjects: Aged, Asian People ethnology, Europe epidemiology, Female, Health Status Disparities, Hospital Mortality ethnology, Humans, Japan epidemiology, Male, Middle Aged, Prevalence, Registries, Shock, Cardiogenic ethnology, Shock, Cardiogenic mortality, Takotsubo Cardiomyopathy mortality, White People ethnology, Asian People statistics & numerical data, Takotsubo Cardiomyopathy ethnology, White People statistics & numerical data
Abstract: Background: Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes., Methods: TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients., Results: A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients., Conclusion: Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers., Trial Registration: URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT01947621., (© 2021. The Author(s).)
Published: 2022
Full Text: View/download PDF

30. Impact of Atrial Fibrillation on Outcome in Takotsubo Syndrome: Data From the International Takotsubo Registry.

Author: El-Battrawy I, Cammann VL, Kato K, Szawan KA, Di Vece D, Rossi A, Wischnewsky M, Hermes-Laufer J, Gili S, Citro R, Bossone E, Neuhaus M, Franke J, Meder B, Jaguszewski M, Noutsias M, Knorr M, Heiner S, D'Ascenzo F, Dichtl W, Burgdorf C, Kherad B, Tschöpe C, Sarcon A, Shinbane J, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Karakas M, Koenig W, Pott A, Meyer P, David Arroja J, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Napp LC, Budnik M, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Chan C, Bridgman P, Beug D, Delmas C, Lairez O, Gilyarova E, Shilova A, Gilyarov M, Kozel M, Tousek P, Winchester DE, Galuszka J, Ukena C, Poglajen G, Carrilho-Ferreira P, Hauck C, Paolini C, Bilato C, Kobayashi Y, Prasad A, Rihal CS, Liu K, Schulze PC, Bianco M, Jörg L, Rickli H, Pestana G, Nguyen TH, Böhm M, Maier LS, Pinto FJ, Widimský P, Felix SB, Opolski G, Braun-Dullaeus RC, Rottbauer W, Hasenfuß G, Pieske BM, Schunkert H, Thiele H, Bauersachs J, Katus HA, Horowitz JD, Di Mario C, Münzel T, Crea F, Bax JJ, Lüscher TF, Ruschitzka F, Duru F, Borggrefe M, Ghadri JR, Akin I, and Templin C
Subjects: Aged, Aged, 80 and over, Atrial Fibrillation diagnosis, Atrial Fibrillation mortality, Atrial Fibrillation therapy, Europe epidemiology, Female, Hospital Mortality, Humans, Male, Middle Aged, Patient Admission, Prevalence, Prognosis, Prospective Studies, Registries, Retrospective Studies, Risk Assessment, Risk Factors, Takotsubo Cardiomyopathy diagnosis, Takotsubo Cardiomyopathy mortality, Takotsubo Cardiomyopathy therapy, Time Factors, United States epidemiology, Atrial Fibrillation epidemiology, Takotsubo Cardiomyopathy epidemiology
Abstract: Background Atrial fibrillation (AF) is a major risk factor for mortality. The prevalence, clinical correlates, and prognostic impact of AF in Takotsubo syndrome (TTS) have not yet been investigated in a large patient cohort. This study aimed to investigate the prevalence, clinical correlates, and prognostic impact of AF in patients with TTS. Methods and Results Patients with TTS were enrolled from the International Takotsubo Registry, which is a multinational network with 26 participating centers in Europe and the United States. Patients were dichotomized according to the presence or absence of AF at the time of admission. Of 1584 patients with TTS, 112 (7.1%) had AF. The mean age was higher ( P <0.001), and there were fewer women ( P =0.046) in the AF than in the non-AF group. Left ventricular ejection fraction was significantly lower ( P =0.001), and cardiogenic shock was more often observed ( P <0.001) in the AF group. Both in-hospital ( P <0.001) and long-term mortality ( P <0.001) were higher in the AF group. Multivariable Cox regression analysis revealed that AF was independently associated with higher long-term mortality (hazard ratio, 2.31; 95% CI, 1.50-3.55; P <0.001). Among patients with AF on admission, 42% had no known history of AF before the acute TTS event, and such patients had comparable in-hospital and long-term outcomes compared with those with a history of AF. Conclusions In patients presenting with TTS, AF on admission is significantly associated with increased in-hospital and long-term mortality rates. Whether antiarrhythmics and/or cardioversion are beneficial in TTS with AF should thus be tested in a future trial. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01947621.
Published: 2021
Full Text: View/download PDF

31. Prognostic impact of acute pulmonary triggers in patients with takotsubo syndrome: new insights from the International Takotsubo Registry.

Author: Kato K, Cammann VL, Napp LC, Szawan KA, Micek J, Dreiding S, Levinson RA, Petkova V, Würdinger M, Patrascu A, Sumalinog R, Gili S, Clarenbach CF, Kohler M, Wischnewsky M, Citro R, Vecchione C, Bossone E, Neuhaus M, Franke J, Meder B, Jaguszewski M, Noutsias M, Knorr M, Heiner S, D'Ascenzo F, Dichtl W, Burgdorf C, Kherad B, Tschöpe C, Sarcon A, Shinbane J, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Karakas M, Koenig W, Pott A, Meyer P, Roffi M, Banning A, Wolfrum M, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Budnik M, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Chan C, Bridgman P, Beug D, Delmas C, Lairez O, Gilyarova E, Shilova A, Gilyarov M, El-Battrawy I, Akin I, Kozel M, Tousek P, Winchester DE, Galuszka J, Ukena C, Poglajen G, Carrilho-Ferreira P, Hauck C, Paolini C, Bilato C, Sano M, Ishibashi I, Takahara M, Himi T, Kobayashi Y, Prasad A, Rihal CS, Liu K, Schulze PC, Bianco M, Jörg L, Rickli H, Pestana G, Nguyen TH, Böhm M, Maier LS, Pinto FJ, Widimský P, Felix SB, Opolski G, Braun-Dullaeus RC, Rottbauer W, Hasenfuß G, Pieske BM, Schunkert H, Borggrefe M, Thiele H, Bauersachs J, Katus HA, Horowitz JD, Di Mario C, Münzel T, Crea F, Bax JJ, Lüscher TF, Ruschitzka F, Ghadri JR, and Templin C
Subjects: Humans, Prognosis, Registries, Shock, Cardiogenic, Survival Analysis, Takotsubo Cardiomyopathy complications, Takotsubo Cardiomyopathy diagnosis, Takotsubo Cardiomyopathy epidemiology
Abstract: Aims: Acute pulmonary disorders are known physical triggers of takotsubo syndrome (TTS). This study aimed to investigate prevalence of acute pulmonary triggers in patients with TTS and their impact on outcomes., Methods and Results: Patients with TTS were enrolled from the International Takotsubo Registry and screened for triggering factors and comorbidities. Patients were categorized into three groups (acute pulmonary trigger, chronic lung disease, and no lung disease) to compare clinical characteristics and outcomes. Of the 1670 included patients with TTS, 123 (7%) were identified with an acute pulmonary trigger, and 194 (12%) had a known history of chronic lung disease. The incidence of cardiogenic shock was highest in patients with an acute pulmonary trigger compared with those with chronic lung disease or without lung disease (17% vs. 10% vs. 9%, P = 0.017). In-hospital mortality was also higher in patients with an acute pulmonary trigger than in the other two groups, although not significantly (5.7% vs. 1.5% vs. 4.2%, P = 0.13). Survival analysis demonstrated that patients with an acute pulmonary trigger had the worst long-term outcome (P = 0.002). The presence of an acute pulmonary trigger was independently associated with worse long-term mortality (hazard ratio 2.12, 95% confidence interval 1.33-3.38; P = 0.002)., Conclusions: The present study demonstrates that TTS is related to acute pulmonary triggers in 7% of all TTS patients, which accounts for 21% of patients with physical triggers. The presence of acute pulmonary trigger is associated with a severe in-hospital course and a worse long-term outcome., (© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
Published: 2021
Full Text: View/download PDF

32. Coexistence and outcome of coronary artery disease in Takotsubo syndrome.

Author: Napp LC, Cammann VL, Jaguszewski M, Szawan KA, Wischnewsky M, Gili S, Knorr M, Heiner S, Citro R, Bossone E, D'Ascenzo F, Neuhaus M, Franke J, Sorici-Barb I, Noutsias M, Burgdorf C, Koenig W, Kherad B, Sarcon A, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Karakas M, Pott A, Meyer P, Arroja JD, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Hauck C, Paolini C, Bilato C, Imori Y, Kato K, Kobayashi Y, Opolski G, Budnik M, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Dichtl W, Chan C, Bridgman P, Beug D, Delmas C, Lairez O, El-Battrawy I, Akin I, Gilyarova E, Shilova A, Gilyarov M, Horowitz JD, Polednikova K, Tousek P, Widimský P, Winchester DE, Galuszka J, Ukena C, Poglajen G, Carrilho-Ferreira P, Di Mario C, Prasad A, Rihal CS, Schulze PC, Bianco M, Crea F, Borggrefe M, Maier LS, Pinto FJ, Braun-Dullaeus RC, Rottbauer W, Katus HA, Hasenfuß G, Tschöpe C, Pieske BM, Thiele H, Schunkert H, Böhm M, Felix SB, Münzel T, Bax JJ, Bauersachs J, Braunwald E, Lüscher TF, Ruschitzka F, Ghadri JR, and Templin C
Subjects: Coronary Angiography, Humans, Incidence, Acute Coronary Syndrome, Coronary Artery Disease complications, Coronary Artery Disease diagnostic imaging, Takotsubo Cardiomyopathy complications, Takotsubo Cardiomyopathy epidemiology
Abstract: Aims: Takotsubo syndrome (TTS) is an acute heart failure syndrome, which shares many features with acute coronary syndrome (ACS). Although TTS was initially described with angiographically normal coronary arteries, smaller studies recently indicated a potential coexistence of coronary artery disease (CAD) in TTS patients. This study aimed to determine the coexistence, features, and prognostic role of CAD in a large cohort of patients with TTS., Methods and Results: Coronary anatomy and CAD were studied in patients diagnosed with TTS. Inclusion criteria were compliance with the International Takotsubo Diagnostic Criteria for TTS, and availability of original coronary angiographies with ventriculography performed during the acute phase. Exclusion criteria were missing views, poor quality of angiography loops, and angiography without ventriculography. A total of 1016 TTS patients were studied. Of those, 23.0% had obstructive CAD, 41.2% had non-obstructive CAD, and 35.7% had angiographically normal coronary arteries. A total of 47 patients (4.6%) underwent percutaneous coronary intervention, and 3 patients had acute and 8 had chronic coronary artery occlusion concomitant with TTS, respectively. The presence of CAD was associated with increased incidence of shock, ventilation, and death from any cause. After adjusting for confounders, the presence of obstructive CAD was associated with mortality at 30 days. Takotsubo syndrome patients with obstructive CAD were at comparable risk for shock and death and nearly at twice the risk for ventilation compared to an age- and sex-matched ACS cohort., Conclusions: Coronary artery disease frequently coexists in TTS patients, presents with the whole spectrum of coronary pathology including acute coronary occlusion, and is associated with adverse outcome., Trial Registration: ClinicalTrials.gov number: NCT01947621., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)
Published: 2020
Full Text: View/download PDF

33. Age-Related Variations in Takotsubo Syndrome.

Author: Cammann VL, Szawan KA, Stähli BE, Kato K, Budnik M, Wischnewsky M, Dreiding S, Levinson RA, Di Vece D, Gili S, Citro R, Bossone E, Neuhaus M, Franke J, Meder B, Jaguszewski M, Noutsias M, Knorr M, Heiner S, D'Ascenzo F, Dichtl W, Burgdorf C, Kherad B, Tschöpe C, Sarcon A, Shinbane J, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Karakas M, Koenig W, Pott A, Meyer P, Roffi M, Banning A, Wolfrum M, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Napp LC, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Chan C, Bridgman P, Beug D, Delmas C, Lairez O, Gilyarova E, Shilova A, Gilyarov M, El-Battrawy I, Akin I, Poledniková K, Toušek P, Winchester DE, Galuszka J, Ukena C, Poglajen G, Carrilho-Ferreira P, Hauck C, Paolini C, Bilato C, Kobayashi Y, Shoji T, Ishibashi I, Takahara M, Himi T, Din J, Al-Shammari A, Prasad A, Rihal CS, Liu K, Schulze PC, Bianco M, Jörg L, Rickli H, Pestana G, Nguyen TH, Böhm M, Maier LS, Pinto FJ, Widimský P, Felix SB, Braun-Dullaeus RC, Rottbauer W, Hasenfuß G, Pieske BM, Schunkert H, Borggrefe M, Thiele H, Bauersachs J, Katus HA, Horowitz JD, Di Mario C, Münzel T, Crea F, Bax JJ, Lüscher TF, Ruschitzka F, Ghadri JR, Opolski G, and Templin C
Subjects: Aged, Causality, Female, Global Health, Humans, Male, Mental Disorders epidemiology, Middle Aged, Mortality, Nervous System Diseases epidemiology, Prevalence, Prognosis, Registries, Risk Assessment statistics & numerical data, Age Factors, Age of Onset, Hospital Mortality, Shock, Cardiogenic epidemiology, Shock, Cardiogenic etiology, Takotsubo Cardiomyopathy complications, Takotsubo Cardiomyopathy diagnosis, Takotsubo Cardiomyopathy epidemiology, Takotsubo Cardiomyopathy physiopathology
Abstract: Background: Takotsubo syndrome (TTS) occurs predominantly in post-menopausal women but is also found in younger patients., Objectives: This study aimed to investigate age-related differences in TTS., Methods: Patients diagnosed with TTS and enrolled in the International Takotsubo Registry between January 2011 and February 2017 were included in this analysis and were stratified by age (younger: ≤50 years, middle-age: 51 to 74 years, elderly: ≥75 years). Baseline characteristics, hospital course, as well as short- and long-term mortality were compared among groups., Results: Of 2,098 TTS patients, 242 (11.5%) patients were ≤50 years of age, 1,194 (56.9%) were 51 to 74 years of age, and 662 (31.6%) were ≥75 years of age. Younger patients were more often men (12.4% vs. 10.9% vs. 6.3%; p = 0.002) and had an increased prevalence of acute neurological (16.3% vs. 8.4% vs. 8.8%; p = 0.001) or psychiatric disorders (14.1% vs. 10.3% vs. 5.6%; p < 0.001) compared with middle-aged and elderly TTS patients. Furthermore, younger patients had more often cardiogenic shock (15.3% vs. 9.1% vs. 8.1%; p = 0.004) and had a numerically higher in-hospital mortality (6.6% vs. 3.6% vs. 5.1%; p = 0.07). At multivariable analysis, younger (odds ratio: 1.60; 95% confidence interval: 0.86 to 3.01; p = 0.14) and older age (odds ratio: 1.09; 95% confidence interval: 0.66 to 1.80; p = 0.75) were not independently associated with in-hospital mortality using the middle-aged group as a reference. There were no differences in 60-day mortality rates among groups., Conclusions: A substantial proportion of TTS patients are younger than 50 years of age. TTS is associated with severe complications requiring intensive care, particularly in younger patients., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Published: 2020
Full Text: View/download PDF

34. Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry.

Author: D'Ascenzo F, Gili S, Bertaina M, Iannaccone M, Cammann VL, Di Vece D, Kato K, Saglietto A, Szawan KA, Frangieh AH, Boffini B, Annaratone M, Sarcon A, Levinson RA, Franke J, Napp LC, Jaguszewski M, Noutsias M, Münzel T, Knorr M, Heiner S, Katus HA, Burgdorf C, Schunkert H, Thiele H, Bauersachs J, Tschöpe C, Pieske BM, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Hasenfuß G, Karakas M, Koenig W, Rottbauer W, Said SM, Braun-Dullaeus RC, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Franz WM, Empen K, Felix SB, Delmas C, Lairez O, El-Battrawy I, Akin I, Borggrefe M, Horowitz JD, Kozel M, Tousek P, Widimský P, Gilyarova E, Shilova A, Gilyarov M, Biondi-Zoccai G, Winchester DE, Ukena C, Neuhaus M, Bax JJ, Prasad A, Di Mario C, Böhm M, Gasparini M, Ruschitzka F, Bossone E, Citro R, Rinaldi M, De Ferrari GM, Lüscher T, Ghadri JR, and Templin C
Subjects: Heart Failure, Humans, Ischemic Attack, Transient, Myocardial Infarction, Platelet Aggregation Inhibitors therapeutic use, Propensity Score, Recurrence, Registries, Stroke, Treatment Outcome, Aspirin therapeutic use, Takotsubo Cardiomyopathy drug therapy, Takotsubo Cardiomyopathy epidemiology
Abstract: Aims: The aim of the present study was to investigate the impact of aspirin on prognosis in takotsubo syndrome (TTS)., Methods and Results: Patients from the International Takotsubo (InterTAK) Registry were categorized into two groups based on aspirin prescription at discharge. A comparison of clinical outcomes between groups was performed using an adjusted analysis with propensity score (PS) stratification; results from the unadjusted analysis were also reported to note the effect of the PS adjustment. Major adverse cardiac and cerebrovascular events (MACCE: a composite of death, myocardial infarction, TTS recurrence, stroke or transient ischaemic attack) were assessed at 30-day and 5-year follow-up. A total of 1533 TTS patients with known status regarding aspirin prescription at discharge were included. According to the adjusted analysis based on PS stratification, aspirin was not associated with a lower hazard of MACCE at 30-day [hazard ratio (HR) 1.24, 95% confidence interval (CI) 0.50-3.04, P = 0.64] or 5-year follow-up (HR 1.11, 95% CI 0.78-1.58, P = 0.58). These results were confirmed by sensitivity analyses performed with alternative PS-based methods, i.e. covariate adjustment and inverse probability of treatment weighting., Conclusion: In the present study, no association was found between aspirin use in TTS patients and a reduced risk of MACCE at 30-day and 5-year follow-up. These findings should be confirmed in adequately powered randomized controlled trials. ClinicalTrials.gov Identifier: NCT01947621., (© 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology.)
Published: 2020
Full Text: View/download PDF

35. Intraventricular Thrombus Formation and Embolism in Takotsubo Syndrome: Insights From the International Takotsubo Registry.

Author: Ding KJ, Cammann VL, Szawan KA, Stähli BE, Wischnewsky M, Di Vece D, Citro R, Jaguszewski M, Seifert B, Sarcon A, Knorr M, Heiner S, Gili S, D'Ascenzo F, Neuhaus M, Napp LC, Franke J, Noutsias M, Burgdorf C, Koenig W, Kherad B, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Karakas M, Pott A, Meyer P, Arroja JD, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Paolini C, Bilato C, Carrilho-Ferreira P, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Dichtl W, Chan C, Bridgman P, Delmas C, Lairez O, El-Battrawy I, Akin I, Gilyarova E, Shilova A, Gilyarov M, Kozel M, Tousek P, Widimský P, Winchester DE, Galuszka J, Ukena C, Horowitz JD, Di Mario C, Prasad A, Rihal CS, Pinto FJ, Crea F, Borggrefe M, Braun-Dullaeus RC, Rottbauer W, Bauersachs J, Katus HA, Hasenfuß G, Tschöpe C, Pieske BM, Thiele H, Schunkert H, Böhm M, Felix SB, Münzel T, Bax JJ, Lüscher TF, Ruschitzka F, Ghadri JR, Bossone E, and Templin C
Subjects: Aged, Australia epidemiology, Coronary Angiography, Electrocardiography, Embolism diagnosis, Embolism epidemiology, Europe epidemiology, Female, Follow-Up Studies, Heart Diseases diagnosis, Heart Diseases epidemiology, Heart Diseases etiology, Heart Ventricles, Humans, Incidence, Magnetic Resonance Imaging, Cine, Male, Radionuclide Ventriculography, Risk Factors, Survival Rate trends, Takotsubo Cardiomyopathy diagnosis, Thrombosis diagnosis, Thrombosis epidemiology, Time Factors, United States epidemiology, Embolism etiology, Registries, Risk Assessment methods, Takotsubo Cardiomyopathy complications, Thrombosis etiology
Abstract: Objective: Takotsubo syndrome (TTS) is characterized by acute left ventricular dysfunction, which can contribute to intraventricular thrombus and embolism. Still, prevalence and clinical impact of thrombus formation and embolic events on outcome of TTS patients remain unclear. This study aimed to investigate clinical features and outcomes of patients with and without intraventricular thrombus or embolism. Additionally, factors associated with thrombus formation or embolism, as well as predictors for mortality, were identified. Approach and Results: TTS patients enrolled in the International Takotsubo Registry at 28 centers in Australia, Europe, and the United States were dichotomized according to the occurrence/absence of intraventricular thrombus or embolism. Patients with intraventricular thrombus or embolism were defined as the ThrombEmb group. Of 1676 TTS patients, 56 (3.3%) patients developed intraventricular thrombus and/or embolism following TTS diagnosis (median time interval, 2.0 days [range, 0-38 days]). Patients in the ThrombEmb group had a different clinical profile including lower left ventricular ejection fraction, higher prevalence of the apical type, elevated levels of troponin and inflammatory markers, and higher prevalence of vascular disease. In a Firth bias-reduced penalized-likelihood logistic regression model apical type, left ventricular ejection fraction ≤30%, previous vascular disease, and a white blood cell count on admission >10×10 3 cells/μL emerged as independent predictors for thrombus formation or embolism., Conclusions: Intraventricular thrombus or embolism occur in 3.3% of patients in the acute phase of TTS. A simple risk score including clinical parameters associated with intraventricular thrombus formation or embolism identifies patients at increased risk., Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01947621.
Published: 2020
Full Text: View/download PDF

36. Clinical Predictors and Prognostic Impact of Recovery of Wall Motion Abnormalities in Takotsubo Syndrome: Results From the International Takotsubo Registry.

Author: Jurisic S, Gili S, Cammann VL, Kato K, Szawan KA, D'Ascenzo F, Jaguszewski M, Bossone E, Citro R, Sarcon A, Napp LC, Franke J, Noutsias M, Knorr M, Heiner S, Burgdorf C, Koenig W, Pott A, Kherad B, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Karakas M, Meyer P, Arroja JD, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Dworakowski R, Kaiser C, Osswald S, Galiuto L, Dichtl W, Chan C, Bridgman P, Beug D, Delmas C, Lairez O, Kozel M, Tousek P, Winchester DE, Gilyarova E, Shilova A, Gilyarov M, El-Battrawy I, Akin I, Galuszka J, Ukena C, Poglajen G, Paolini C, Bilato C, Carrilho-Ferreira P, Pinto FJ, Opolski G, MacCarthy P, Kobayashi Y, Prasad A, Rihal CS, Widimský P, Horowitz JD, Di Mario C, Crea F, Tschöpe C, Pieske BM, Hasenfuß G, Rottbauer W, Braun-Dullaeus RC, Felix SB, Borggrefe M, Thiele H, Bauersachs J, Katus HA, Schunkert H, Münzel T, Böhm M, Bax JJ, Lüscher TF, Ruschitzka F, Ghadri JR, and Templin C
Subjects: Aged, Female, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Registries, Retrospective Studies, Switzerland, Time Factors, Recovery of Function, Takotsubo Cardiomyopathy physiopathology
Abstract: 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: NCT01947621.
Published: 2019
Full Text: View/download PDF

37. Clinical Features and Outcomes of Patients With Malignancy and Takotsubo Syndrome: Observations From the International Takotsubo Registry.

Author: Cammann VL, Sarcon A, Ding KJ, Seifert B, Kato K, Di Vece D, Szawan KA, Gili S, Jurisic S, Bacchi B, Micek J, Frangieh AH, Napp LC, Jaguszewski M, Bossone E, Citro R, D'Ascenzo F, Franke J, Noutsias M, Knorr M, Heiner S, Burgdorf C, Koenig W, Thiele H, Tschöpe C, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Karakas M, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Dworakowski R, Kaiser C, Osswald S, Galiuto L, Dichtl W, Delmas C, Lairez O, Horowitz JD, Kozel M, Widimský P, Tousek P, Winchester DE, Gilyarova E, Shilova A, Gilyarov M, El-Battrawy I, Akin I, Ukena C, Bauersachs J, Pieske BM, Hasenfuß G, Rottbauer W, Braun-Dullaeus RC, Opolski G, MacCarthy P, Felix SB, Borggrefe M, Di Mario C, Crea F, Katus HA, Schunkert H, Münzel T, Böhm M, Bax JJ, Prasad A, Shinbane J, Lüscher TF, Ruschitzka F, Ghadri JR, and Templin C
Subjects: Aged, Female, Humans, International Cooperation, Male, Middle Aged, Neoplasms complications, Prospective Studies, Registries, Retrospective Studies, Takotsubo Cardiomyopathy complications, Time Factors, Neoplasms diagnosis, Neoplasms mortality, Takotsubo Cardiomyopathy diagnosis, Takotsubo Cardiomyopathy mortality
Abstract: Background Clinical characteristics and outcomes of takotsubo syndrome (TTS) patients with malignancy have not been fully elucidated. This study sought to explore differences in clinical characteristics and to investigate short- and long-term outcomes in TTS patients with or without malignancy. Methods and Results TTS patients were enrolled from the International Takotsubo Registry. The TTS cohort was divided into patients with and without malignancy to investigate differences in clinical characteristics and to assess short- and long-term mortality. A subanalysis was performed comparing long-term mortality between a subset of TTS patients with or without malignancy and acute coronary syndrome (ACS) patients with or without malignancy. Malignancy was observed in 16.6% of 1604 TTS patients. Patients with malignancy were older and more likely to have physical triggers, but less likely to have emotional triggers compared with those without malignancy. Long-term mortality was higher in patients with malignancy (P<0.001), while short-term outcome was comparable (P=0.17). In a subanalysis, long-term mortality was comparable between TTS patients with malignancies and ACS patients with malignancies (P=0.13). Malignancy emerged as an independent predictor of long-term mortality. Conclusions A substantial number of TTS patients show an association with malignancy. History of malignancy might increase the risk for TTS, and therefore, appropriate screening for malignancy should be considered in these patients. Clinical Trial Registration URL: http://www.clinicaltrial.gov. Unique identifier: NCT01947621.
Published: 2019
Full Text: View/download PDF

38. Cardiac arrest in takotsubo syndrome: results from the InterTAK Registry.

Author: Gili S, Cammann VL, Schlossbauer SA, Kato K, D'Ascenzo F, Di Vece D, Jurisic S, Micek J, Obeid S, Bacchi B, Szawan KA, Famos F, Sarcon A, Levinson R, Ding KJ, Seifert B, Lenoir O, Bossone E, Citro R, Franke J, Napp LC, Jaguszewski M, Noutsias M, Münzel T, Knorr M, Heiner S, Katus HA, Burgdorf C, Schunkert H, Thiele H, Bauersachs J, Tschöpe C, Pieske BM, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Hasenfuß G, Karakas M, Koenig W, Rottbauer W, Said SM, Braun-Dullaeus RC, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Empen K, Felix SB, Delmas C, Lairez O, El-Battrawy I, Akin I, Borggrefe M, Gilyarova E, Shilova A, Gilyarov M, Horowitz JD, Kozel M, Tousek P, Widimský P, Winchester DE, Ukena C, Gaita F, Di Mario C, Wischnewsky MB, Bax JJ, Prasad A, Böhm M, Ruschitzka F, Lüscher TF, Ghadri JR, and Templin C
Subjects: Female, Heart Arrest diagnosis, Heart Arrest epidemiology, Heart Arrest mortality, Humans, Male, Middle Aged, Prognosis, Registries, Retrospective Studies, Survival Analysis, Heart Arrest etiology, Takotsubo Cardiomyopathy complications
Abstract: Aims: We aimed to evaluate the frequency, clinical features, and prognostic implications of cardiac arrest (CA) in takotsubo syndrome (TTS)., Methods and Results: We reviewed the records of patients with CA and known heart rhythm from the International Takotsubo Registry. The main outcomes were 60-day and 5-year mortality. In addition, predictors of mortality and predictors of CA during the acute TTS phase were assessed. Of 2098 patients, 103 patients with CA and known heart rhythm during CA were included. Compared with patients without CA, CA patients were more likely to be younger, male, and have apical TTS, atrial fibrillation (AF), neurologic comorbidities, physical triggers, and longer corrected QT-interval and lower left ventricular ejection fraction on admission. In all, 57.1% of patients with CA at admission had ventricular fibrillation/tachycardia, while 73.7% of patients with CA in the acute phase had asystole/pulseless electrical activity. Patients with CA showed higher 60-day (40.3% vs. 4.0%, P < 0.001) and 5-year mortality (68.9% vs. 16.7%, P < 0.001) than patients without CA. T-wave inversion and intracranial haemorrhage were independently associated with higher 60-day mortality after CA, whereas female gender was associated with lower 60-day mortality. In the acute phase, CA occurred less frequently in females and more frequently in patients with AF, ST-segment elevation, and higher C-reactive protein on admission., Conclusions: Cardiac arrest is relatively frequent in TTS and is associated with higher short- and long-term mortality. Clinical and electrocardiographic parameters independently predicted mortality after CA., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Published: 2019
Full Text: View/download PDF

39. Outcomes Associated With Cardiogenic Shock in Takotsubo Syndrome.

Author: Di Vece D, Citro R, Cammann VL, Kato K, Gili S, Szawan KA, Micek J, Jurisic S, Ding KJ, Bacchi B, Schwyzer M, Candreva A, Bossone E, D'Ascenzo F, Sarcon A, Franke J, Napp LC, Jaguszewski M, Noutsias M, Münzel T, Knorr M, Heiner S, Katus HA, Burgdorf C, Schunkert H, Thiele H, Bauersachs J, Tschöpe C, Pieske BM, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Hasenfuβ G, Karakas M, Koenig W, Rottbauer W, Said SM, Braun-Dullaeus RC, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Empen K, Felix SB, Delmas C, Lairez O, El-Battrawy I, Akin I, Borggrefe M, Gilyarova E, Shilova A, Gilyarov M, Horowitz J, Kozel M, Tousek P, Widimský P, Winchester DE, Ukena C, Di Mario C, Prasad A, Böhm M, Bax JJ, Lüscher TF, Ruschitzka F, Ghadri JR, and Templin C
Subjects: Aged, Comorbidity, Female, Hospital Mortality, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Registries, Retrospective Studies, Risk Assessment, Risk Factors, Shock, Cardiogenic mortality, Shock, Cardiogenic physiopathology, Takotsubo Cardiomyopathy mortality, Takotsubo Cardiomyopathy physiopathology, Time Factors, Shock, Cardiogenic therapy, Takotsubo Cardiomyopathy therapy
Published: 2019
Full Text: View/download PDF

40. Long-Term Prognosis of Patients With Takotsubo Syndrome.

Author: Ghadri JR, Kato K, Cammann VL, Gili S, Jurisic S, Di Vece D, Candreva A, Ding KJ, Micek J, Szawan KA, Bacchi B, Bianchi R, Levinson RA, Wischnewsky M, Seifert B, Schlossbauer SA, Citro R, Bossone E, Münzel T, Knorr M, Heiner S, D'Ascenzo F, Franke J, Sarcon A, Napp LC, Jaguszewski M, Noutsias M, Katus HA, Burgdorf C, Schunkert H, Thiele H, Bauersachs J, Tschöpe C, Pieske BM, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Hasenfuß G, Karakas M, Koenig W, Rottbauer W, Said SM, Braun-Dullaeus RC, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Empen K, Felix SB, Delmas C, Lairez O, El-Battrawy I, Akin I, Borggrefe M, Horowitz J, Kozel M, Tousek P, Widimský P, Gilyarova E, Shilova A, Gilyarov M, Winchester DE, Ukena C, Bax JJ, Prasad A, Böhm M, Lüscher TF, Ruschitzka F, and Templin C
Subjects: Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome mortality, Acute Coronary Syndrome physiopathology, Aged, Aged, 80 and over, Electroencephalography mortality, Electroencephalography trends, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mortality trends, Nervous System Diseases diagnosis, Nervous System Diseases physiopathology, Prognosis, Stress, Psychological diagnosis, Stress, Psychological mortality, Stress, Psychological physiopathology, Takotsubo Cardiomyopathy physiopathology, Takotsubo Cardiomyopathy psychology, Time Factors, Registries, Takotsubo Cardiomyopathy diagnosis, Takotsubo Cardiomyopathy mortality
Abstract: Background: Prognosis of Takotsubo syndrome (TTS) remains controversial due to scarcity of available data. Additionally, the effect of the triggering factors remains elusive., Objectives: This study compared prognosis between TTS and acute coronary syndrome (ACS) patients and investigated short- and long-term outcomes in TTS based on different triggers., Methods: Patients with TTS were enrolled from the International Takotsubo Registry. Long-term mortality of patients with TTS was compared to an age- and sex-matched cohort of patients with ACS. In addition, short- and long-term outcomes were compared between different groups according to triggering conditions., Results: Overall, TTS patients had a comparable long-term mortality risk with ACS patients. Of 1,613 TTS patients, an emotional trigger was detected in 485 patients (30%). Of 630 patients (39%) related to physical triggers, 98 patients (6%) had acute neurologic disorders, while in the other 532 patients (33%), physical activities, medical conditions, or procedures were the triggering conditions. The remaining 498 patients (31%) had no identifiable trigger. TTS patients related to physical stress showed higher mortality rates than ACS patients during long-term follow-up, whereas patients related to emotional stress had better outcomes compared with ACS patients., Conclusions: Overall, TTS patients had long-term outcomes comparable to age- and sex-matched ACS patients. Also, we demonstrated that TTS can either be benign or a life-threating condition depending on the inciting stress factor. We propose a new classification based on triggers, which can serve as a clinical tool to predict short- and long-term outcomes of TTS. (International Takotsubo Registry [InterTAK Registry]; NCT01947621)., (Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Published: 2018
Full Text: View/download PDF

41. Therapeutic implications of a combined diagnostic workup including endomyocardial biopsy in an all-comer population of patients with heart failure: a retrospective analysis.

Author: Sotiriou E, Heiner S, Jansen T, Brandt M, Schmidt KH, Kreitner KF, Emrich T, Schultheiss HP, Schulz E, Münzel T, and Wenzel P
Subjects: Cardiac Catheterization, Echocardiography, Electrocardiography, Female, Follow-Up Studies, Heart Failure physiopathology, Heart Failure therapy, Humans, Immunosuppressive Agents therapeutic use, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Prognosis, Retrospective Studies, Stroke Volume physiology, Biopsy methods, Disease Management, Heart Failure diagnosis, Myocardium pathology
Abstract: Background: Aetiology of heart failure (HF) often remains obscure. We therefore evaluated the usefulness of a combined diagnostic approach including cardiac magnetic resonance imaging (CMRI) and endomyocardial biopsy (EMB) to assess the cause of unexplained cardiomyopathy underlying HF., Methods and Results: We retrospectively investigated 100 consecutive patients (36% women, mean age 53.6 ± 18.8 years) presenting with unexplained cardiomyopathy (HF with reduced ejection fraction or left ventricular hypertrophy; excluding ischaemic and valvular heart disease; left ventricular ejection fraction 31.6 ± 13.9%, Left ventricular end-diastolic pressure 18.2 ± 9.3 mmHg, heart rate 89 ± 26.6 b.p.m.; mean ± SEM) at the University Medical Center Mainz. We performed electrocardiography, echocardiography, CMRI, and cardiac catheterization with EMB analysed at a Food and Drug Administration-approved reference centre in 100%, 94%, 69%, and 100% of patients, respectively. On the basis of CMRI findings, electrocardiography, echocardiography, and medical history, the exact cause of cardiomyopathy remained uncertain in 37 of 69 cases (53.6%). In EMB, 25% of patients had viral replication, 23% had inflammation defined as lymphocytic infiltrations without active virus replication, 1% had giant cell myocarditis, and 1% had eosinophilic myocarditis. After diagnostic workup including EMB findings, the cause of cardiomyopathy remained unidentified in 14% of the cases, classified as idiopathic dilated cardiomyopathy or hypertrophic cardiomyopathy in 10% or 4%, respectively. EMB helped to discuss a causal treatment strategy of HF involving immunosuppression or antiviral treatment in 53% of patients, which was opted for in 12% of the patients., Conclusions: A comprehensive workup including imaging and EMB in an all-comer population of patients with HF may help physicians to improve diagnostics of unexplained cardiomyopathy in the majority of cases., (© 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)
Published: 2018
Full Text: View/download PDF

42. Executive and behavioral deficits share common neural substrates in frontotemporal lobar degeneration - a pilot FDG-PET study.

Author: Raczka KA, Becker G, Seese A, Frisch S, Heiner S, Marschhauser A, Barthel H, Scheid R, Sabri O, and Schroeter ML
Subjects: Aged, Female, Fluorodeoxyglucose F18, Humans, Male, Mental Status Schedule, Middle Aged, Neuropsychological Tests, Pilot Projects, Positron-Emission Tomography methods, Statistics as Topic, Behavioral Symptoms diagnostic imaging, Behavioral Symptoms etiology, Behavioral Symptoms pathology, Brain Mapping, Cognition Disorders diagnostic imaging, Cognition Disorders etiology, Cognition Disorders pathology, Executive Function physiology, Frontotemporal Lobar Degeneration complications, Frontotemporal Lobar Degeneration diagnostic imaging, Frontotemporal Lobar Degeneration pathology
Abstract: Behavioral and executive dysfunctions are typical symptoms of frontotemporal lobar degeneration, associated with its subtypes frontotemporal and semantic dementia. Although both functions depend on the frontal lobes, no study has yet compared their neural correlates in frontotemporal lobar degeneration. Accordingly, we correlated clinical scores of behavioral and executive deficits with glucose utilization as measured by [(18)F]fluorodeoxyglucose positron emission tomography in 17 patients with frontotemporal lobar degeneration and 9 age- and sex-matched control subjects. Impairment in executive functions was measured by the Behavioral Assessment of the Dysexecutive Syndrome, a modified Stroop paradigm and/or the Tower of Toronto Test. Behavioral deficits were examined with the Neuropsychiatric Inventory. Executive dysfunction was correlated with diminished glucose utilization in frontomedial and frontolateral cortices. Brain regions included the anterior cingulate and midcingulate gyri, anterior medial frontal cortex, and left frontolateral cortex. Behavioral deficits were associated with mainly frontomedial networks, particularly the anterior medial frontal cortex, gyrus rectus, and area subcallosa. Our pilot study reveals partially overlapping neural correlates of executive and behavioral dysfunction in frontotemporal lobar degeneration. The results suggest that some behavioral deficits, namely disinhibition and appetite and eating abnormalities, are particularly related to executive dysfunction. This hypothesis might be further explored in studies involving larger patient groups.
Published: 2010
Full Text: View/download PDF

43. Effects of an augmented postoperative fluid protocol on wound healing in cardiac surgery patients.

Author: Heiner S, Whitney JD, Wood C, and Mygrant BI
Subjects: Adolescent, Adult, Aged, Aged, 80 and over, Analysis of Variance, Body Temperature, Chi-Square Distribution, Female, Humans, Hydroxyproline analysis, Male, Middle Aged, Oxygen metabolism, Perfusion, Postoperative Complications epidemiology, Prevalence, Treatment Outcome, Cardiac Surgical Procedures, Fluid Therapy, Postoperative Complications prevention & control, Wound Healing physiology
Abstract: Background: Cardiac surgery patients are vulnerable to hypoperfusion postoperatively and often have subcutaneous tissue oxygen tension less than 50 mm Hg. Hypovolemia most likely contributes to this hypoperfusion and may lead to impaired wound healing., Objectives: To determine if a modified postoperative fluid replacement protocol would result in improved tissue oxygen tension, blood flow, and healing in cardiothoracic surgery patients., Methods: A total of 166 cardiac surgery patients, 18 to 90 years old, participated in a randomized, 2-group, repeated-measures study. The experimental group received fluid augmentation during the first 36 hours after surgery; the control group received standard postoperative replacement fluids. Subcutaneous tissue oxygen tension and temperature were measured 8, 18, and 36 hours after surgery. Tissue cellularity and accumulation of hydroxyproline were evaluated in tissue obtained from subcutaneous expanded polytetrafluoroethylene tubes. Wound complications were evaluated by using the ASEPSIS Wound Scoring System., Results: Tissue oxygen levels, tissue cellularity, and accumulation of hydroxyproline were similar in the 2 groups. A negative correlation (P = .01) existed between higher tissue oxygen values and lower (better) ASEPSIS leg wound scores. More than 80% of the patients had tissue oxygen levels of 50 mm Hg or less at each time of measure. Many values were 30 to 40 mm Hg less than the ideal for control of bacteria and healing., Conclusions: The frequency of low oxygen levels is consistent with data from earlier studies. Determination of other interventions to improve subcutaneous tissue perfusion in cardiac surgery patients is needed.
Published: 2002

44. Tissue and wound healing effects of short duration postoperative oxygen therapy.

Author: Whitney JD, Heiner S, Mygrant BI, and Wood C
Subjects: Adult, Aged, Female, Humans, Hydroxyproline metabolism, Male, Manometry methods, Middle Aged, Oxygen metabolism, Pilot Projects, Statistics, Nonparametric, Surgical Wound Infection prevention & control, Oxygen Inhalation Therapy, Postoperative Care, Wound Healing
Abstract: The purpose of this study was to determine the effects of 28% oxygen given in the first 36 hours after surgery on tissue oxygen, collagen deposition, and clinical healing outcomes. Twenty-four subjects having cervical spine surgical procedures participated in a randomized, repeated-measures pilot study of tissue and healing effects of postoperative supplemental oxygen. The treatment group (n = 13) received 28% oxygen for the first 36 postoperative hours, whereas the control group (n = 11) was maintained on room air. Subcutaneous tissue oxygen and temperature were measured at intervals up to 36 hours postsurgery. Wound healing was evaluated by hydroxyproline content in a subcutaneous polytetrafluoroethylene tube removed on the 7th postoperative day. Clinical outcomes were evaluated for the 30 days post-hospital discharge. Subjects in the treatment group had significantly higher tissue oxygen tension overall, and at postoperative hours 1, 2, 18, and 36, with mean values 10 to 20 mm Hg higher than control subjects. Significant differences were not found in hydroxyproline levels or clinical wound outcome measures. Low level, short duration, supplemental oxygen increased and sustained wound tissue oxygen and was well tolerated by subjects. Larger studies of populations at risk for wound complications are needed to investigate variables of dose and duration of oxygen therapy in relation to clinical and cellular wound healing outcomes.
Published: 2001
Full Text: View/download PDF

45. Cellular response to orthodontic force.

Author: Roberts WE, Goodwin WC Jr, and Heiner SR
Subjects: Alveolar Process physiology, Bone Resorption physiopathology, Humans, Osteoblasts physiology, Osteoclasts physiology, Osteogenesis, Periodontal Ligament physiology, Stress, Mechanical, Alveolar Process cytology, Tooth Movement Techniques
Abstract: Orthodontic force systems, by way of stress/strain, are transduced to a biologic signal that affects a multifaceted bone remodeling response. Tooth movement involves not only a periodontal ligament response (alveolus translocation), but also bursts of resorption associated with truncated remodeling events in the path of the advancing tooth. Osteoclasts are recruited primarily from the macrophage/monocyte series, whereas osteoblasts are produced by local periodontal ligament cell proliferation and differentiation. Based on nuclear size, periodontal cells are a multicompartmental population. The relatively large nuclei (D fraction) are the immediate precursors of osteoblasts, and the cells with small nuclei (A fraction are apparently the undifferentiated, germinal compartment.
Published: 1981

Catalog

Books, media, physical & digital resources

See catalog results

Searchworks

Select search scope, currently: Articles Catalog books, media & more in Jio Institute collections Articles journal articles & other e-resources

Search

Search Constraints

Refine your results

Search Limiters

Topic

Publication Year Range

Language

Publication Type

Journal

Region

Database

Publisher

45 results on '"Heiner, S"'

Search Results

Catalog

Select search scope, currently: Articles

Catalog

books, media & more in Jio Institute collections

Articles

journal articles & other e-resources