Short- and Long-Term Prognosis of Patients With Takotsubo Syndrome Based on Different Triggers: Importance of the Physical Nature.

Uribarri, AitorNúñez-Gil, Iván JConty, D AritzaVedia, OscarAlmendro-Delia, ManuelDuran Cambra, AlbertMartin-Garcia, Agustin CBarrionuevo-Sánchez, MarisaMartínez-Sellés, ManuelRaposeiras-Roubín, SergioGuillén, MartaGarcia Acuña, Jose MariaMatute-Blanco, LucíaLinares Vicente, José ASánchez Grande Flecha, AlejandroAndrés, MireiaPérez-Castellanos, AlbertoLopez-Pais, JavierRETAKO Investigators2023-02-082023-02-082019-12-13http://hdl.handle.net/10668/14820Background Takotsubo syndrome (TTS) is an acute reversible heart condition initially believed to represent a benign pathology attributable to its self-limiting clinical course; however, little is known about its prognosis based on different triggers. This study compared short- and long-term outcomes between TTS based on different triggers, focusing on various physical triggering events. Methods and Results We analyzed patients with a definitive TTS diagnosis recruited for the Spanish National Registry on TTS (RETAKO [Registry on Takotsubo Syndrome]). Short- and long-term outcomes were compared between different groups according to triggering factors. A total of 939 patients were included. An emotional trigger was detected in 340 patients (36.2%), a physical trigger in 293 patients (31.2%), and none could be identified in 306 patients (32.6%). The main physical triggers observed were infections (30.7%), followed by surgical procedures (22.5%), physical activities (18.4%), episodes of severe hypoxia (18.4%), and neurological events (9.9%). TTS triggered by physical factors showed higher mortality in the short and long term, and within this group, patients whose physical trigger was hypoxia were those who had a worse prognosis, in addition to being triggered by physical factors, including age >70 years, diabetes mellitus, left ventricular eyection fraction 70 years, diabetes mellitus, left ventricular eyection fractionenAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Takotsubo cardiomyopathybroken heart syndromeclassificationoutcomestressstress‐induced cardiomyopathyAgedAged, 80 and overEmotionsFemaleHumansMaleMiddle AgedPrognosisStress, PhysiologicalStress, PsychologicalTakotsubo CardiomyopathyTime FactorsShort- and Long-Term Prognosis of Patients With Takotsubo Syndrome Based on Different Triggers: Importance of the Physical Nature.research article31830875open access10.1161/JAHA.119.0137012047-9980PMC6951081https://doi.org/10.1161/jaha.119.013701https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6951081/pdf