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Type: Journal article
Title: Dissociation of early shock in Takotsubo cardiomyopathy from either right or left ventricular systolic dysfunction
Author: Singh, K.
Neil, C.
Nguyen, T.
Stansborough, J.
Chong, C.
Dawson, D.
Frenneaux, M.
Horowitz, J.
Citation: Heart, Lung and Circulation, 2014; 23(12):1141-1148
Publisher: Elsevier
Issue Date: 2014
ISSN: 1443-9506
Statement of
Kuljit Singh, Christopher J. Neil, Thanh Ha Nguyen, Jeanette Stansborough, Cher-Rin Chong, Dana Dawson, Michael P. Frenneaux, John D. Horowitz
Abstract: BACKGROUND: Takotsubo cardiomyopathy (TTC) is often associated with hypotension and shock. However, development of hypotension/shock in TTC is not closely related to extent of left ventricular (LV) hypokinesis. We sought to determine whether additional right ventricular (RV) involvement in TTC might contribute to hypotension and shock development and thus to prolonged hospital stay (PHS). METHODS: We evaluated 102 consecutive TTC patients with acute transthoracic echocardiography (TTE) to detect RV hypokinesis. Correlates of hypotension, shock and PHS were identified by univariate and multivariate analyses. RESULTS: Of the 102 patients evaluated, 33% had RV hypokinesis but only 9% had extensive RV involvement. Within the first 24 hours of admission, severe hypotension (systolic blood pressure (SBP) ≤ 90 mmHg) occurred in 21% of the patients and shock (hypotension + peripheral organ hypo-perfusion) in 16.6% of cases. RV involvement was a univariate but not a multivariate correlate of either hypotension or shock and did not result in PHS. On the other hand, RV involvement predicted more extensive LV hypokinesis and LV systolic dysfunction. CONCLUSIONS: In TTC, RV hypokinesis occurs in approximately 33% of cases and correlates with more severe LV wall motion abnormality but not with development of hypotension or shock. These data therefore reinforce previous findings that hypotension/shock in TTC are not purely by impaired cardiac output.
Keywords: Takotsubo Cardiomyopathy; Right ventricle; Hypotension; Shock; Stress cardiomyopathy
Description: Online published-ahead-of-print 27 June 2014
Rights: © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
RMID: 0030069187
DOI: 10.1016/j.hlc.2014.06.010
Appears in Collections:Medicine publications

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