P4518In-hospital complications among Takotsubo Cardiomyopathy patients. Preliminary data from a prospective multicenter registry

Abstract

Background: Takotsubo cardiomyopathy (TTC) is an acute and reversible left ventricular dysfunction, whose pathophysiological mechanisms are not completely known. Aim of the study is to evaluate in-hospital complications and potential predictors in a large cohort of TTC patients. Methods: One hundred ninety eight consecutive patients admitted for TTC were enrolled from July 2007 to June 2016 in a prospective registry among four hospitals. Clinical features, laboratory data, ECG and echocardiographic parameters and in-hospital complications were recorded. Results: Forty-three (22%) patients, mean age 77±10 years, developed acute in hospital-complications. Compared to the control group, patients that experienced in-hospital complications were older (77 vs 70 years, p=0.01), there was a higher prevalence of male sex (28% vs 7% p=0.01), ST segment elevation at admission (53% vs. 36%, p=0.03) and involvement of the right ventricle (16% vs 2%, p=0.002). In-hospital complications were classified into cardiovascular one (58% pulmonary oedema, 14% non-invasive mechanical ventilation, 7% cardiogenic shock, 2% arrhythmias and 2% ischemic stroke) and non-cardiovascular one (7% including psychomotor agitation, pneumonia and anemia). In-hospital mortality among these patients was 7%. At multivariate analysis corrected for age, gender, ejection fraction and STelevation at admission EGG, right ventricular involvement was the only independent predictor of in-hospital complications (OR 7.4, CI 95% 1.5-36.9, p=0.01). Conclusions: High rate of complications during the acute phase of Takotsubo Cardiomyopathy is observed. Right ventricular involvement at admission is a predictor of such events and therefore should be carefully evaluated at admission echocardiogram.