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. 2019 May 7;8(9):e010753.
doi: 10.1161/JAHA.118.010753.

Incidence and Clinical Impact of Recurrent Takotsubo Syndrome: Results From the GEIST Registry

Ibrahim El-Battrawy  1   2 , Francesco Santoro  3 , Thomas Stiermaier  4 , Christian Möller  4 , Francesca Guastafierro  3 , Giuseppina Novo  5 , Salvatore Novo  5 , Enrica Mariano  6 , Francesco Romeo  6 , Fabiana Romeo  6 , Holger Thiele  7 , Federico Guerra  8 , Alessandro Capucci  8 , Irene Giannini  8 , Natale Daniele Brunetti  3 , Ingo Eitel  4 , Ibrahim Akin  1   2
Affiliations

Incidence and Clinical Impact of Recurrent Takotsubo Syndrome: Results From the GEIST Registry

Ibrahim El-Battrawy et al. J Am Heart Assoc. .

Abstract

Background Current literature only reports variable information from single-center studies on the recurrence rate, the complications, and the outcome of patients with Takotsubo syndrome ( TTS) experiencing recurrent TTS . Therefore, a detailed description of clinical characteristics, predictors, and the prognostic impact of patients with TTS and recurrences in a multicenter registry is needed. Methods and Results We analyzed 749 patients with TTS from 9 European centers being part of the international, multicenter GEIST (German Italian Stress Cardiomyopathy) Registry. Patients were divided into the recurrence group and the nonrecurrence group. The recurrence rate at a median follow-up of 830 days (interquartile range, 118-1701 days) was 4%. Most recurrences were documented in the first 5 years after the index TTS episode. Up to 2 TTS recurrences were documented in 2 of 30 patients (6%). A variable ballooning pattern (n=6, 0.8%) with, in particular, involvement of the right ventricular occurred in 3 cases (0.4%) at the recurrence event. Except for the higher presence of arterial hypertension (86.7% versus 68.3%; P=0.03) in the recurrence group, no other baseline characteristics were different between groups. Observation of TTS complications during follow-up, including stroke, thromboembolic events, in-hospital death, and cardiogenic shock, revealed no significant differences between groups ( P>0.05), except the higher presence of pulmonary edema in the recurrence group versus the nonrecurrence group (13.3% versus 4.9%; P=0.04). Conclusions The incidence of TTS recurrence is estimated to be 4% in this multicenter TTS registry. A variable TTS pattern at recurrence is common in up to 20% of recurrence cases.

Keywords: Takotsubo cardiomyopathy; heart failure; recurrence.

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Figures

Figure 1
Figure 1
Recurrence‐free survival presents that most recurrences are common the first years after a Takotsubo syndrome event.
See this image and copyright information in PMC

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