Risk stratification in Takotsubo Syndrome: a role of mitral annular plane systolic excursion.

Risk stratification in Takotsubo Syndrome: a role of mitral annular plane systolic excursion.

QJM. 2018 Jan 15;:

Authors: El-Battrawy I, Ansari U, Lang S, Fastner C, Zhou X, Borggrefe M, Akin I

Abstract
Aims: Takotsubo syndrome (TTS) patients have a higher mortality rate than the general population. Our study was conducted to determine the short- and long-term outcome of TTS patients associated with a significantly compromised mitral annular plane systolic excursion (MAPSE) on hospital admission.
Methods and results: Our institutional database constituted a collective of 53 patients diagnosed with TTS between 2003 and 2016. The patients were classified into two groups based on the MAPSE, with those presenting with a MAPSE <1 cm on admission categorized into one group (n = 20, 38%) and those presenting with MAPSE ≥1 cm (n = 33, 62%) categorized into another group. Preliminary results indicated that patients with a MAPSE<1 cm had a greater risk of developing thromboembolic events. The long-term mortality was significantly higher in TTS patients with a MAPSE<1 cm. In the multivariate Cox regression analysis, cardiogenic shock (HR 3.5; 95%CI 1.2-10.7; p = 0.02) and MAPSE<1 cm (HR 5.1; 95%CI 1.3-19.2; p = 0.01) figured as independent predictors of the mortality.
Conclusion: Whereas the short-term mortality rate among TTS patients diagnosed with a reduced MAPSE on admission as similar as without reduced MAPSE, the long-term mortality rates among TTS patients diagnosed with a reduced MAPSE on admission were significantly higher. There is an urgent need for randomized trials, which could help define uniform clinical management strategies for high risk TTS patients.

PMID: 29346679 [PubMed - as supplied by publisher]

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