Management of Takotsubo cardiomyopathy in non-academic hospitals in France: The Observational French SyndromEs of TakoTsubo (OFSETT) study
Komlavi Yayehd, N'kenon W N'da, Loïc Belle, Vincent Bataille, Michel Hanssen, Pierre Leddet, Jean-François Aupetit, Philippe Commeau, Emmanuelle Filippi, Jean-Louis Georges, Franck Albert, Grégoire Rangé, Patrick Meimoun, Xavier Marcaggi, Serge Baleynaud, Olivier Nallet, Alain Dibie, Claude Barnay, Bernard Jouve, Maud Legrand, Simon Cattan, Geneviève Mulak, Tabassome Simon, Nicolas Danchin, Jean-Jacques Dujardin, OFSETT investigators, Hanssen, Aupetit, Commeau, Filippi, Belle, Georges, Albert, Meimoun, Marcaggi, Baleynaud, Cattan, Dibie, Barnay, Legrand, Komlavi Yayehd, N'kenon W N'da, Loïc Belle, Vincent Bataille, Michel Hanssen, Pierre Leddet, Jean-François Aupetit, Philippe Commeau, Emmanuelle Filippi, Jean-Louis Georges, Franck Albert, Grégoire Rangé, Patrick Meimoun, Xavier Marcaggi, Serge Baleynaud, Olivier Nallet, Alain Dibie, Claude Barnay, Bernard Jouve, Maud Legrand, Simon Cattan, Geneviève Mulak, Tabassome Simon, Nicolas Danchin, Jean-Jacques Dujardin, OFSETT investigators, Hanssen, Aupetit, Commeau, Filippi, Belle, Georges, Albert, Meimoun, Marcaggi, Baleynaud, Cattan, Dibie, Barnay, Legrand
Abstract
Background: Takotsubo cardiomyopathy (TTC) is a rare condition characterized by a sudden temporary weakening of the heart. TTC can mimic acute myocardial infarction and is associated with a minimal release of myocardial biomarkers in the absence of obstructive coronary artery disease.
Aims: To provide an extensive description of patients admitted to hospital for TTC throughout France and to study the management and outcomes of these patients.
Methods: In 14 non-academic hospitals, we collected clinical, electrocardiographic, biological, psychological and therapeutic data in patients with a diagnosis of TTC according to the Mayo Clinic criteria.
Results: Of 117 patients, 91.5% were women, mean ± SD age was 71.4 ± 12.1 years and the prevalence of risk factors was high (hypertension: 57.9%, dyslipidaemia: 33.0%, diabetes: 11.5%, obesity: 11.5%). The most common initial symptoms were chest pain (80.5%) and dyspnoea (24.1%). A triggering psychological event was detected in 64.3% of patients. ST-segment elevation was found in 41.7% of patients and T-wave inversion in 71.6%. Anterior leads were most frequently associated with ST-segment elevation, whereas T-wave inversion was more commonly associated with lateral leads, and Q-waves with septal leads. The ratio of peak B-type natriuretic peptide (BNP) or N-terminal prohormone BNP (NT-proBNP) level to peak troponin level was 1.01. No deaths occurred during the hospital phase. After 1 year of follow-up, 3 of 109 (2.8%) patients with available data died, including one cardiovascular death. Rehospitalizations occurred in 17.4% of patients: 2.8% due to acute heart failure and 14.7% due to non-cardiovascular causes. There was no recurrence of TTC.
Conclusions: This observational study of TTC included primarily women with atherosclerotic risk factors and mental stress. T-wave inversion was more common than ST-segment elevation. There were few adverse cardiovascular outcomes in these patients after 1-year follow-up.
Keywords: B-type natriuretic peptide; ST-segment elevation; Sus-décalage ST; Syndrome de Takotsubo; Takotsubo cardiomyopathy.
Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Source: PubMed