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Predictors Of Early Left Ventricular Recovery In Takotsubo Syndrome: A Single-Center Study
Session:
Sessão de Posters 21 - Por dentro do miocárdio: da genética aos resultados
Speaker:
Beatriz Vargas Andrade
Congress:
CPC 2026
Topic:
P. Other
Theme:
37. Miscellanea
Subtheme:
---
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Beatriz Vargas Andrade; João Cravo; Sofia Esteves; Daniel Cazeiro; Marta Vilela; Diogo Ferreira; Pedro Carrilho Ferreira; Pedro Cardoso; Fausto J. Pinto
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Introduction: </span></strong><span style="font-size:11.0pt">Takotsubo syndrome (TTS) typically presents with acute, left ventricular systolic dysfunction characterized by wall motion abnormalities which are usually reversible over days to weeks. However, timing and completeness of left ventricular ejection fraction (LVEF) recovery are heterogeneous, and clinical predictors of early recovery remain only partially understood.</span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Purpose: </span></strong><span style="font-size:11.0pt">To identify potential predictors of LVEF recovery at discharge in patients with TTS.</span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Methods: </span></strong><span style="font-size:11.0pt">We conducted a retrospective, single-center study including patients diagnosed with TTS between 2008 and 2025. Demographic, clinical, echocardiographic, and laboratory data were collected from admission to discharge. Patients were categorized according to LVEF recovery status at discharge. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of LVEF recovery.</span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Results: </span></strong><span style="font-size:11.0pt">A total of 137 patients (mean age 72±17 years, 85% female) were included, 85% of whom with the classical TTS pattern. An identifiable trigger was documented in 69% of cases, of which 53% were acute physical stressors. Overall, 58% of patients had reduced LVEF on admission, with recovery at discharge observed in 53% of them. On univariate analysis, younger age (69.5y vs. 76.1y, p=0.014; OR 1.053, 95% CI </span><span style="font-size:11.0pt">[</span><span style="font-size:11.0pt">1.009–1.099</span><span style="font-size:11.0pt">]</span><span style="font-size:11.0pt">, p=0.018), higher LVEF on admission (40.2% vs.32.5%, p<0.001; OR 1.207, 95% CI </span><span style="font-size:11.0pt">[1.096-1.33</span><span style="font-size:11.0pt">0</span><span style="font-size:11.0pt">], </span><span style="font-size:11.0pt">p<0.001), and presence of an identifiable emotional stressor (OR 3.3, 95% CI </span><span style="font-size:11.0pt">[1.131-9.804],</span><span style="font-size:11.0pt"> p=0.029) were associated with LVEF recovery. Inflammatory and myocardial injury biomarkers (C-reactive protein, troponin T, and NT-proBNP) did not differ between groups. On multivariate analysis, only higher LVEF was an independent predictor of LVEF recovery at discharge (OR 1.39, 95% CI </span><span style="font-size:11.0pt">[</span><span style="font-size:11.0pt">1.136-1.704</span><span style="font-size:11.0pt">],</span><span style="font-size:11.0pt"> p=0.001).</span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Discussion and conclusion: </span></strong><span style="font-size:11.0pt">In this cohort of TTS patients, higher baseline LVEF independently predicted early recovery of LVEF at discharge. Younger age and emotional stressors also appeared to favor recovery, though without independent significance. These findings suggest that initial LVEF is a key determinant of short-term ventricular improvement, underlining the potential importance of early echocardiographic assessment in prognostic evaluation.</span></span></span></p>
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