TY - JOUR
T1 - Clinical correlates and prognostic impact of neurologic disorders in Takotsubo syndrome
AU - InterTAK Consortium
AU - Cammann, Victoria L.
AU - Scheitz, Jan F.
AU - von Rennenberg, Regina
AU - Jäncke, Lutz
AU - Nolte, Christian H.
AU - Szawan, Konrad A.
AU - Stengl, Helena
AU - Würdinger, Michael
AU - Endres, Matthias
AU - Templin, Christian
AU - Ghadri, Jelena R.
AU - Citro, Rodolfo
AU - Vecchione, Carmine
AU - Bossone, Eduardo
AU - Gili, Sebastiano
AU - Neuhaus, Michael
AU - Franke, Jennifer
AU - Meder, Benjamin
AU - Jaguszewski, Miłosz
AU - Noutsias, Michel
AU - Knorr, Maike
AU - Jansen, Thomas
AU - D’Ascenzo, Fabrizio
AU - Dichtl, Wolfgang
AU - Burgdorf, Christof
AU - Kherad, Behrouz
AU - Tschöpe, Carsten
AU - Sarcon, Annahita
AU - Shinbane, Jerold
AU - Rajan, Lawrence
AU - Michels, Guido
AU - Pfister, Roman
AU - Cuneo, Alessandro
AU - Jacobshagen, Claudius
AU - Karakas, Mahir
AU - Koenig, Wolfgang
AU - Pott, Alexander
AU - Meyer, Philippe
AU - Roffi, Marco
AU - Banning, Adrian
AU - Wolfrum, Mathias
AU - Cuculi, Florim
AU - Kobza, Richard
AU - Fischer, Thomas A.
AU - Vasankari, Tuija
AU - Airaksinen, K. E.Juhani
AU - Napp, L. Christian
AU - Dworakowski, Rafal
AU - MacCarthy, Philip
AU - Schunkert, Heribert
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Cardiac alterations are frequently observed after acute neurological disorders. Takotsubo syndrome (TTS) represents an acute heart failure syndrome and is increasingly recognized as part of the spectrum of cardiac complications observed after neurological disorders. A systematic investigation of TTS patients with neurological disorders has not been conducted yet. The aim of the study was to expand insights regarding neurological disease entities triggering TTS and to investigate the clinical profile and outcomes of TTS patients after primary neurological disorders. The International Takotsubo Registry is an observational multicenter collaborative effort of 45 centers in 14 countries (ClinicalTrials.gov, identifier NCT01947621). All patients in the registry fulfilled International Takotsubo Diagnostic Criteria. For the present study, patients were included if complete information on acute neurological disorders were available. 2402 patients in whom complete information on acute neurological status were available were analyzed. In 161 patients (6.7%) an acute neurological disorder was identified as the preceding triggering factor. The most common neurological disorders were seizures, intracranial hemorrhage, and ischemic stroke. Time from neurological symptoms to TTS diagnosis was ≤ 2 days in 87.3% of cases. TTS patients with neurological disorders were younger, had a lower female predominance, fewer cardiac symptoms, lower left ventricular ejection fraction, and higher levels of cardiac biomarkers. TTS patients with neurological disorders had a 3.2-fold increased odds of in-hospital mortality compared to TTS patients without neurological disorders. In this large-scale study, 1 out of 15 TTS patients had an acute neurological condition as the underlying triggering factor. Our data emphasize that a wide spectrum of neurological diseases ranging from benign to life-threatening encompass TTS. The high rates of adverse events highlight the need for clinical awareness.
AB - Cardiac alterations are frequently observed after acute neurological disorders. Takotsubo syndrome (TTS) represents an acute heart failure syndrome and is increasingly recognized as part of the spectrum of cardiac complications observed after neurological disorders. A systematic investigation of TTS patients with neurological disorders has not been conducted yet. The aim of the study was to expand insights regarding neurological disease entities triggering TTS and to investigate the clinical profile and outcomes of TTS patients after primary neurological disorders. The International Takotsubo Registry is an observational multicenter collaborative effort of 45 centers in 14 countries (ClinicalTrials.gov, identifier NCT01947621). All patients in the registry fulfilled International Takotsubo Diagnostic Criteria. For the present study, patients were included if complete information on acute neurological disorders were available. 2402 patients in whom complete information on acute neurological status were available were analyzed. In 161 patients (6.7%) an acute neurological disorder was identified as the preceding triggering factor. The most common neurological disorders were seizures, intracranial hemorrhage, and ischemic stroke. Time from neurological symptoms to TTS diagnosis was ≤ 2 days in 87.3% of cases. TTS patients with neurological disorders were younger, had a lower female predominance, fewer cardiac symptoms, lower left ventricular ejection fraction, and higher levels of cardiac biomarkers. TTS patients with neurological disorders had a 3.2-fold increased odds of in-hospital mortality compared to TTS patients without neurological disorders. In this large-scale study, 1 out of 15 TTS patients had an acute neurological condition as the underlying triggering factor. Our data emphasize that a wide spectrum of neurological diseases ranging from benign to life-threatening encompass TTS. The high rates of adverse events highlight the need for clinical awareness.
UR - https://www.scopus.com/pages/publications/85121130077
U2 - 10.1038/s41598-021-01496-9
DO - 10.1038/s41598-021-01496-9
M3 - Article
C2 - 34876622
AN - SCOPUS:85121130077
SN - 2045-2322
VL - 11
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 23555
ER -