Key result
The combination of poorer global longitudinal strain and higher impaired microvascular resistance in Takotsubo syndrome patients was associated with a higher 1-year MACE rate (60.0% vs 22.2%).
Why the study?
It was unknown whether acute-phase global longitudinal strain provides incremental prognostic value to the degree of impaired microvascular resistance in Takotsubo syndrome patients.
Observational (n=67)
No
Absolute Event Rate: 60% vs 22.2%
p-value: p=0.0373
GLS assessment in acute TTS may refine 1-year prognosis beyond MR; leaves open its clinical utility pending prospective validation.
Background : Global longitudinal strain (GLS) allows an accurate assessment of left ventricular function with prognostic value. We aimed to evaluate whether the assessment of GLS in the acute phase of Takotsubo syndrome (TTS) provides incremental prognostic value to the degree of impaired microvascular resistance (MR) in TTS patients at 1-year follow-up. Methods: We recruited 78 consecutive patients admitted for TTS who underwent cardiac angiography and echocardiography from January 2017 to June 2021. Left anterior descending coronary artery non-hyperaemic angiography-derived index of microcirculatory resistance (LAD NH-IMRangio) was calculated. NT-proBNP, high-sensitive cardiac troponin T (hs-cTnT), left ventricular ejection fraction (LVEF) and GLS were measured at admission. Major adverse cardiac events (MACE) were defined as the composite of cardiovascular death, heart failure (HF) events, symptomatic arrythmias and acute myocardial infarctions. Results: 67 patients had both GLS and NH-IMRangio available. Median age was 75.2 years and 88 % were women. Rate of MACE at 1-year was 23.9% mainly due to mild HF events. Kaplan-Meier curves showed higher rates of MACE at 1-year in patients with both higher LAD NH-IMRangio and GLS values compared with those with higher LAD NH-IMRangio and lower GLS values (60.0% vs 22.2%; p=0.0373). NT-proBNP levels at admission and the recovery of LVEF were correlated with GLS values while MR and hs-cTnT were not. Conclusions: GLS provides incremental prognostic value to the degree of impaired MR in TTS patients. The combination of a poorer GLS with a higher degree of impaired MR was associated with a higher rate of MACE in these patients.
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Sans‐Roselló et al. (2022) conducted an observational in Takotsubo syndrome (n=67). Higher LAD NH-IMRangio and higher global longitudinal strain (GLS) vs. Higher LAD NH-IMRangio and lower GLS was evaluated on Major adverse cardiac events (MACE) at 1-year follow-up (p=0.0373). The combination of poorer global longitudinal strain and higher impaired microvascular resistance in Takotsubo syndrome patients was associated with a higher 1-year MACE rate (60.0% vs 22.2%).
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