[Clinical spectrum of tako-tsubo cardiomyopathy in Germany: results of the tako-tsubo registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)]

Dtsch Med Wochenschr. 2010 Oct;135(39):1908-13. doi: 10.1055/s-0030-1263337. Epub 2010 Sep 21.
[Article in German]

Abstract

Background: Tako-tsubo cardiomyopathy (TTC) was first described in 1990 in Japan. A TTC registry was initiated by the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK) in order to evaluate the clinical spectrum and the management of patients with this syndrome in Germany.

Methods: Patients from 37 hospitals were included in the registry if they fulfilled the following criteria: 1. acute chest symptoms or syncope, 2. new ischemic ECG changes with ST-segment elevation ± T-wave inversion, 3. reversible left ventricular regional wall motion abnormality not corresponding to a single coronary artery territory, 4. absence of significant coronary artery stenoses.

Results: 296 of the 324 patients (age 68 ± 12) were women (91 %) and 28 men (9 %). Leading symptoms were angina pectoris (72 %), dyspnoea (16 %), syncope (3 %) or resuscitation/cardiogenic shock (2 %). An antecedent trigger was found in 77 %. Time from symptom onset to hospital admission was 7,6 ± 6,9 hours. An acute coronary syndrome (ACS) was clinically suspected in 87 %. The ECG showed ST-segment elevation in 85 %. Cardiac troponin was elevated in more than 90 % of patients. Left ventricular ejection fraction by angiography was reduced to 49 ± 14 %. Initial medical treatment corresponded to the working diagnosis of an ACS. Catecholamines or an intraaortic balloon pump were necessary in 5 % and 1 %, respectively. Seven patients (2.2 %) died in hospital.

Conclusion: TTC afflicts mainly women and presents clinically as an ACS in 87 %. Hospital mortality is low with symptomatic therapy.

Publication types

  • English Abstract

MeSH terms

  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / epidemiology
  • Acute Coronary Syndrome / etiology
  • Adult
  • Aged
  • Aged, 80 and over
  • Coronary Angiography
  • Creatine Kinase / blood
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Electrocardiography
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Registries*
  • Risk Factors
  • Takotsubo Cardiomyopathy / diagnosis*
  • Takotsubo Cardiomyopathy / epidemiology
  • Takotsubo Cardiomyopathy / etiology
  • Troponin T / blood

Substances

  • Troponin T
  • Creatine Kinase