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Incidence and Clinical Impact of Right Ventricular Involvement (Biventricular Ballooning) in Takotsubo Syndrome: Results From the GEIST Registry.
- Source :
- CHEST; Oct2021, Vol. 160 Issue 4, p1433-1441, 9p
- Publication Year :
- 2021
-
Abstract
- <bold>Background: </bold>The short- and long-term prognosis of Takotsubo syndrome (TTS) presenting with right ventricular (RV) involvement remains poorly understood.<bold>Research Question: </bold>What is the incidence and clinical outcome of RV involvement in TTS?<bold>Study Design and Methods: </bold>This study analyzed 839 consecutive patients with TTS (758 female subjects and 81 male subjects) in a multicenter registry. RV involvement was defined as wall motion abnormality of the RV free wall, with or without apical involvement. The median long-term follow-up was 2.1 years (interquartile range, 0.3-4.5 years). The primary outcome was in-hospital and out-of-hospital all-cause mortality. The secondary end point was a composite of in-hospital death, thromboembolic events, cardiogenic shock, pulmonary edema, and malignant arrhythmias.<bold>Results: </bold>The incidence of RV involvement in TTS was 11% (n = 93). More often patients with RV involvement were male compared with patients without RV involvement (P = .02). There was a slight difference in the left ventricular ejection fraction measured in patients with RV involvement vs those patients with isolated left ventricular TTS (38 ± 10% vs 40 ± 10%; P = .03). No major differences in terms of comorbidities were observed between groups except regarding a history of cancer, which was significantly more prevalent in patients with TTS presenting with RV involvement (P = .03). Physical stressors were more prevalent in the RV group (P < .01), whereas emotional stressors were less prevalent (P < .01). Patients with RV involvement had a higher incidence of in-hospital cardiogenic shock (P = .02). The primary outcome (in- and out-of-hospital all-cause mortality) was observed in 12.8% of patients without RV involvement compared with 29% of patients with RV involvement. Although the in-hospital mortality rate was similar in both groups, a higher out-of-hospital all-cause mortality rate (log-rank test, P = .008) was observed in the RV involvement group. The Cox multivariable regression analysis showed that physical triggers were independent predictors of RV involvement.<bold>Interpretation: </bold>RV involvement defines a high-risk cohort of patients with TTS.<bold>Clinical Trial Registration: </bold>ClinicalTrials.gov; No.: NCT04361994; URL: www.clinicaltrials.gov. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00123692
- Volume :
- 160
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- CHEST
- Publication Type :
- Academic Journal
- Accession number :
- 152712704
- Full Text :
- https://doi.org/10.1016/j.chest.2021.04.072