Late recovery of LV function tied to poor survival in patients with Takotsubo syndrome

In patients with Takotsubo syndrome (TTS), late recovery of left ventricular (LV) function appears to contribute to reduced short- and long-term survival, suggests a study.

In this study, the authors reviewed the prospective serial imaging data from the nationwide, multicentre RETAKO* to assess the timing of LV recovery. They also examined the factors associated with late (≥10 days) vs early (<10 days) recovery using multivariable logistic regression.

The authors then compared the long-term risk of all-cause mortality between patients with late and early LV recovery using fully adjusted Cox models, as well as flexible parametric survival models with recovery time included as a continuous variable.

A total of 1,463 patients (median age 73 years, 13 percent men) were included in the study. Of these, 373 (25 percent) had late and 1,090 (75 percent) had early LV recovery.

Late recovery was associated independently with the following factors: older age, history of neurological disorders, bystander coronary artery disease, active cancer, physical triggers, elevated inflammatory biomarkers, cardiogenic shock, and lower LV ejection fraction at admission.

At 4-year follow-up, patients with late recovery showed a significantly greater adjusted risk of death than those with early recovery (16.0 percent vs 8.6 percent; adjusted hazard ratio [aHR], 1.31, 95 percent confidence interval [CI], 1.12‒1.60). This mortality risk rose by 8 percent for each additional 10-day delay in time-to-LV recovery (aHR, 1.08, 95 percent CI, 1.04‒1.13).

“In TTS patients without early LV recovery, closer clinical follow-up might be considered,” the authors said.

*REgistry on TAKOtsubo Syndrome