Prevalence and Clinical Features of Focal Takotsubo Cardiomyopathy

• Published in: Circulation Journal 2016/07/25, Vol.80(8), pp.1824-1829
• Main Authors: Kato, Ken, Kitahara, Hideki, Fujimoto, Yoshihide, Sakai, Yoshiaki, Ishibashi, Iwao, Himi, Toshiharu, Kobayashi, Yoshio
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Aged; Aged, 80 and over; Apical ballooning syndrome; Female; Humans; Left ventriculography; Male; Middle Aged; Prevalence; Registries; Takotsubo cardiomyopathy; Takotsubo Cardiomyopathy - diagnosis; Takotsubo Cardiomyopathy - diagnostic imaging; Takotsubo Cardiomyopathy - epidemiology; Takotsubo Cardiomyopathy - physiopathology
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-16-0360

Background:Because it is difficult to distinguish between focal takotsubo cardiomyopathy and aborted myocardial infarction, there is little information about the prevalence and clinical features of focal takotsubo cardiomyopathy.Methods and Results:Our cardiac catheterization databases were queried to identify patients with focal takotsubo cardiomyopathy and other types of takotsubo cardiomyopathy. We defined focal takotsubo cardiomyopathy as hypo-, a- or dyskinesis in both anterolateral and septal segments without obstructive coronary artery disease explaining the wall motion abnormality. A total of 10 patients were diagnosed with focal takotsubo cardiomyopathy. The control group comprised patients with takotsubo cardiomyopathy with apical, mid-ventricular, or basal ballooning. Clinical features and in-hospital outcomes were compared between patients with focal takotsubo cardiomyopathy and those with other types of takotsubo cardiomyopathy. Among the 144 patients with takotsubo cardiomyopathy, the apical, mid-ventricular, basal, and focal types occurred in 85 (59.0%), 49 (34.0%), 0 (0%), and 10 patients (6.9%), respectively. The left ventricular ejection fraction was significantly higher in the focal group compared with the apical and mid-ventricular group (56±13 vs. 45±13 vs. 46±12%, P=0.03). In-hospital outcome was not significantly different among the 3 groups.Conclusions:Focal takotsubo cardiomyopathy is not rare. Biplane left ventriculography is useful for its diagnosis. (Circ J 2016; 80: 1824–1829)