Key result
Takotsubo syndrome occurs in ~1% of ACS presentations, with complete LVEF recovery at one month.
Why the study?
The incidence and clinical course of takotsubo syndrome in patients with acute coronary syndrome at a single PCI center over 7 years were not well characterized.
Observational (n=2,298)
No
Takotsubo syndrom (TTS) je akutnĂ a obvykle reverzibilnĂ syndrom srdeÄnĂho selhĂĄnĂ. Klinicky k nerozeznĂĄnĂ imituje akutnĂ koronĂĄrnĂ syndrom s/a nebo bez elevacĂ Ăşseku ST na elektrokardiogramu. Je charakterizovĂĄn akutnĂ poruchou myokardiĂĄlnĂ kontraktility vÄtĹĄinou apikĂĄlnĂ ÄĂĄsti levĂŠ srdeÄnĂ komory pĹi absenci okluzivnĂ koronĂĄrnĂ nemoci. TvoĹĂ 1–2 % pacientĹŻ pĹijatĂ˝ch pro akutnĂ koronĂĄrnĂ syndrom. Jeho prognĂłza byla dosud povaĹžovĂĄna za velmi dobrou, ale recentnĂ informace z dlouhodobĂŠho registru ukazujĂ, Ĺže krĂĄtko- i dlouhodobĂĄ prognĂłza je stejnÄ zĂĄvaĹžnĂĄ, jako u akutnĂch koronĂĄrnĂch syndromĹŻ. Etiologie je neznĂĄmĂĄ a lĂŠÄba symptomatickĂĄ. MĹŻĹže bĂ˝t komplikovĂĄn tranzientnĂ dynamickou obstrukcĂ ve vĂ˝tokovĂŠm traktu levĂŠ komory, obÄhovou nestabilitou a dysrytmiemi. CĂl studie: RetrospektivnĂ analĂ˝za incidence a klinickĂŠho prĹŻbÄhu TTS u pacientĹŻ s akutnĂm koronĂĄrnĂm syndromem (ACS) v jedinĂŠm PCI centru v obdobĂ 84 mÄsĂcĹŻ. VĂ˝sledky: V danĂŠm obdobĂ bylo urgentnÄ provedeno celkem 2 298 selektivnĂch koronarografiĂ a diagnĂłza TTS byla stanovena u 21 (0,9 %) pacientĹŻ, 20 (95 %) bylo ĹženskĂŠho pohlavĂ, prĹŻmÄrnĂ˝ vÄk 63,7 ± 10,5 (49–84) roku. Dle EKG obrazu bylo 9 (43 %) STEMI a 12 (57 %) NSTEMI. PrĹŻmÄrnĂĄ ejekÄnĂ frakce levĂŠ komory srdeÄnĂ (LVEF) byla 47 ± 9,1 (35–65) %. Po ÄtyĹech tĂ˝dnech bylo kontrolovĂĄno 18 (86 %) nemocnĂ˝ch, u vĹĄech doĹĄlo ke kompletnĂ ĂşpravÄ poruchy kinetiky levĂŠ komory srdeÄnĂ s EFLV 63,5 ± 8,9 (50–80) %. ÄtyĹtĂ˝dennĂ mortalita byla nulovĂĄ. ZĂĄvÄr: Incidence Takotsubo syndromu u nemocnĂ˝ch s ACS je v naĹĄem souboru ve shodÄ s literĂĄrnĂmi Ăşdaji nĂzkĂĄ. K validnĂ analĂ˝ze krĂĄtkodobĂŠ prognĂłzy je nĂĄĹĄ soubor pĹĂliĹĄ malĂ˝.
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Holm et al. (2019) conducted an observational in Acute Coronary Syndrome / Takotsubo Syndrome (n=2,298). Acute coronary syndrome was evaluated on Incidence of Takotsubo syndrome. The incidence of Takotsubo syndrome among patients presenting with acute coronary syndrome was 0.9% (21 out of 2,298), with complete restoration of left ventricular ejection fraction observed in all followed patients after one month.
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