Key result
Atypical left ventricular ballooning patterns in recurrent Takotsubo cardiomyopathy were associated with a 63% lower odds of severe adverse events (cardiogenic shock and cardiac arrest) compared to typical apical patterns.
Why the study?
Recurrent takotsubo cardiomyopathy, the clinical profiles and outcomes of patients, and the effect of left ventricular ballooning pattern had not been fully evaluated.
Does an atypical left ventricular ballooning pattern reduce severe adverse events compared to a typical pattern in patients with recurrent Takotsubo cardiomyopathy?
Meta-Analysis (n=101)
Does an atypical left ventricular ballooning pattern reduce severe adverse events compared to a typical pattern in patients with recurrent Takotsubo cardiomyopathy?
In patients with recurrent Takotsubo cardiomyopathy, an atypical left ventricular ballooning pattern is associated with significantly lower odds of severe adverse events compared to a typical apical pattern.
Answers are grounded in this paper and cite their sources.
Atypical ballooning in recurrent TTC was associated with fewer severe events; leaves open whether pattern refines risk stratification.
Recurrent takotsubo cardiomyopathy (TTC) and the clinical profiles and outcomes of patients have not been fully evaluated, nor has the effect of left ventricular ballooning pattern. After searching the medical literature for reports of patients with recurrent TTC, we identified 84 articles with 101 case descriptions. We divided the cases into those with only apical left ventricular ballooning patterns at recurrence (typical, n=60), and those with at least one midventricular or basal ballooning pattern (atypical, n=41). We then compared their clinical profiles and outcomes. The groups were similar in terms of baseline demographic characteristics, presence and types of triggers, use of heart failure medications at TTC recurrence, electrocardiographic changes at presentation, initial left ventricular ejection fractions, timespans between recurrent TTC episodes, and recovery times after each event. However, patients in the atypical group had significantly fewer severe adverse events (cardiogenic shock and cardiac arrest) than did those in the typical group, with an estimated 63% lower odds (adjusted odds ratio=0.37; 95% CI, 0.14-0.97; P=0.039). Survival to hospital discharge was statistically similar but lower in the typical group (n=53; 88.3%) than in the atypical group (n=24; 96%). Our results suggest that left ventricular ballooning patterns influence clinical outcomes, and that outcomes are more favorable in patients with recurrent TTC who have atypical left ventricular ballooning patterns.
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A 2021 study conducted a meta-analysis in Recurrent Takotsubo cardiomyopathy (n=101). Atypical left ventricular ballooning pattern (midventricular or basal) vs. Typical left ventricular ballooning pattern (apical) was evaluated on Severe adverse events (cardiogenic shock and cardiac arrest) (adjusted OR 0.37, 95% CI 0.14-0.97, p=0.039). Atypical left ventricular ballooning patterns in recurrent Takotsubo cardiomyopathy were associated with a 63% lower odds of severe adverse events (cardiogenic shock and cardiac arrest) compared to typical apical patterns.
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