SPC365

Clinical Features and Outcomes of Takotsubo Syndrome

Session: SESSÃO DE POSTERS 33 - DOENÇAS CARDIOVASCULARES - MINOCA E SÍNDROME DE TAKOTSUBO
Speaker: João Pedro Dantas Martins Neves

Congress: CPC 2025
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 13. Acute Coronary Syndromes
Subtheme: 13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type: Cartazes
FP Number: ---
Authors: João Martins Neves; Catarina Gregório; Ana Abrantes; Miguel Azaredo Raposo; Diogo Ferreira; Daniel Inácio Cazeiro; Marta Vilela; João Fonseca; João Cravo; Inês Araújo; Fausto J. Pinto; Dulce Brito

<p style="text-align:justify"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Introduction</span></span></span></strong></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Takotsubo syndrome (TS) is characterized by a transient systolic and diastolic left ventricular dysfunction with a variety of wall-motion abnormalities. It has been increasingly recognized, but a comprehensive understanding of its clinical approach remains incomplete.</span></span></span></p>

<p style="text-align:justify"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Purpose</span></span></span></strong></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">To describe the clinical characteristics, triggering factors and outcomes of TS.&nbsp;</span></span></span></p>

<p style="text-align:justify"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Methods</span></span></span></strong></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">A retrospective analysis of TS patients admitted to a tertiary hospital between 2008 and 2023&nbsp; was conducted.&nbsp; We collected patient data, including baseline characteristics, laboratory values, results on electrocardiography (ECG), cardiac imaging and coronary angiography (CA), and major adverse outcomes &ndash; defined as a composite outcome of cardiogenic shock, acute pulmonary oedema (APE), ventricular arrhythmias (VA), high-grade atrioventricular block (HGAVB) and stroke. Descriptive statistic and univariate analysis were performed.&nbsp;</span></span></span></p>

<p style="text-align:justify"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Results</span></span></span></strong></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Ninety eight patients were included&nbsp; (86% women, mean age 77 &plusmn; 11 years). Of them, 83% had arterial hypertension, 29% diabetes, 53% dyslipidaemia, and 38% neuropsychiatric disorders (mainly anxiety and depression).</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">The predominant symptom on admission was chest pain (76%). A trigger was identified in 61% of patients, being physical triggers more frequent than emotional (63% vs 37%).&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">ECG on admission showed ST-segment elevation in 52% of cases, T-wave inversion in 60%, and ST-segment depression in 12%; the mean QTc interval was 463 ms. Mean NT-proBNP and troponin T maximum levels were 4483 pg/mL and 511 ng/L, respectively. A reduced left ventricular ejection fraction (LVEF) was observed in 82% of patients (mean value 42&plusmn;8%) at admission. Apical TS was identified in 95% of patients, whereas the midventricular form was found in 3%, and left ventricular outflow tract obstruction in 2 cases. Cardiac magnetic resonance revealed oedema in 29% of patients and late gadolinium enhancement was absent in 83% of cases.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">All patients performed CA, obstructive coronary artery disease was diagnosed in 9% and percutaneous intervention was done in 4%. Left ventriculography identified apical ballooning pattern in 76% of patients.&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">During hospital admission, the rate of major adverse events was 23%, being HGAVB, APE and VA the most frequent. Physical triggers and reduced LVEF on admission were predictors of adverse events (p=0,001 and p=0,045, respectively).&nbsp;&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion</span></span></strong></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">TS represents an acute heart failure syndrome in which psychological and physical factors interplay, with substantial morbidity associated</span></span></span></p>