Abstract 12379: The Impact of Right Ventricular Involvement on Prognosis of Takotsubo Cardiomyopathy
Background: Takotsubo cardiomyopathy (TC) is characterized by acute and transient left ventricular mid wall motion abnormality with or without apical involvement. Although TC has been recognized as a self-limiting and benign disease, recent studies have suggested that some critical complications may occur in TC. Moreover, recent studies have suggested that TC with right ventricular (RV) involvement is associated with higher incidence of in-hospital complications than those without it. The aim of this study was to elucidate the long-term prognostic impact of RV involvement in TC.
Methods: We retrospectively studied the clinical and echocardiographic data of 113 patients (72.7±11.4 years old, 29 male) with TC diagnosed according to the Mayo clinic criteria. They were divided into 2 groups based on the presence (group R) or absence (group L) of the RV involvement. RV involvement was defined by akinesis or dyskinesis of the RV free wall with or without apical involvement assessed by echocardiography on admission. The endpoint of this study was a composite of all-cause death and re-hospitalization due to heart failure.
Results: Twenty one patients (18.6%, 16 female) were classified as group R and 92 patients (81.4%, 68 female) as group L. Group R had significantly lower event free survival than group L (figure). Univariate analysis showed that heart rate on admission (HR 1.01/bpm, p=0.014), advanced heart failure defined as Killip class≥3 (HR 3.56, p=0.01), left ventricular ejection fraction (HR 0.95/%, p=0.0028), RV involvement (HR 6.35, p<0.001) and wall motion score index (HR 5.25, p=0.014) were the predictors of the endpoint. By multivariate analysis, RV involvement was the only independent predictor of the endpoint (HR 3.07, p=0.048).
Conclusion: RV involvement is an independent predictor of poor prognosis in TC.
Author Disclosures: N. Kagiyama: None. H. Okura: None. T. Tamada: None. K. Imai: None. R. Yamada: None. T. Kume: None. A. Hayashida: None. Y. Neishi: None. K. Yamamoto: None. K. Yoshida: None.
- © 2014 by American Heart Association, Inc.