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. 2019 Sep 8;8(9):1411.
doi: 10.3390/jcm8091411.

Tachycardiomyopathy in Patients without Underlying Structural Heart Disease

Giulia Stronati  1 , Federico Guerra  2 , Alessia Urbinati  1 , Giuseppe Ciliberti  1 , Laura Cipolletta  1 , Alessandro Capucci  1
Affiliations

Tachycardiomyopathy in Patients without Underlying Structural Heart Disease

Giulia Stronati et al. J Clin Med. .

Abstract

Tachycardiomyopathy (TCM) is an underestimated cause of reversible left ventricle dysfunction. The aim of this study was to identify the predictors of recurrence and incidence of major cardiovascular events in TCM patients without underlying structural heart disease (pure TCM). The prospective, observational study enrolled all consecutive pure TCM patients. The diagnosis was suspected in patients admitted for heart failure (HF) with a reduced ejection fraction and concomitant persistent arrhythmia. Pure TCM was confirmed after the clinical and echocardiographic recovery during follow-up. From 107 pure TCM patients (9% of all HF admission, the median follow-up 22.6 months), 17 recurred, 51 were hospitalized for cardiovascular reasons, two suffered from thromboembolic events and one died. The diagnosis of obstructive sleep apnoea syndrome (OSAS, hazard ratio (HR) 5.44), brain natriuretic peptide on admission (HR 1.01 for each pg/mL) and the heart rate at discharge (HR 1.05 for each bpm) were all independent predictors of TCM recurrence. The left ventricular ejection fraction at discharge (HR 0.96 for each%) and the heart rate at discharge (HR 1.02 for each bpm) resulted as independent predictors of cardiovascular-related hospitalization. Pure TCM is more common than previously thought and associated with a good long-term survival but recurrences and hospitalizations are frequent. Reversing OSAS and controlling the heart rate could prevent TCM-related complications.

Keywords: arrhythmias; atrial fibrillation; cardiomyopathy; heart failure; supraventricular arrhythmia; systolic dysfunction; tachycardiomyopathy; ventricular arrhythmia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Selection process.
Figure 2
Figure 2
Time free from tachycardiomyopathy recurrence according to the Kaplan-Meier curves.s.
Figure 3
Figure 3
The mean values of the heart rate (a) and let ventricular ejection fraction (b) during follow-up, according to the presence or absence of future recurrences.
Figure 4
Figure 4
Time free from hospitalization for cardiovascular reasons according to the Kaplan-Meier curves.
See this image and copyright information in PMC

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