Comparison and outcome analysis of patients with takotsubo cardiomyopathy triggered by emotional stress or physical stress

Background: Previous studies revealed that Takotsubo cardiomyopathy (TTC) is triggered by physical and emotional stresses. This study was performed to determine the short- and long-term prognostic impact of emotional- and physical stress associated with TTC. Methods and results: Our institutional da...

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Main Authors: Giannakopoulos, Konstantinos (Author) , El-Battrawy, Ibrahim (Author) , Schramm, Katja (Author) , Ansari, Uzair (Author) , Hoffmann, Ursula (Author) , Borggrefe, Martin (Author) , Akın, Ibrahim (Author)
Format: Article (Journal)
Language:English
Published: 27 April 2017
In: Frontiers in psychology
Year: 2017, Volume: 8
ISSN:1664-1078
DOI:10.3389/fpsyg.2017.00527
Online Access:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.3389/fpsyg.2017.00527
Verlag, kostenfrei, Volltext: https://www.frontiersin.org/articles/10.3389/fpsyg.2017.00527/full
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Author Notes:Konstantinos Giannakopoulos, Ibrahim El-Battrawy, Katja Schramm, Uzair Ansari, Ursula Hoffmann, Martin Borggrefe and Ibrahim Akin

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520 |a Background: Previous studies revealed that Takotsubo cardiomyopathy (TTC) is triggered by physical and emotional stresses. This study was performed to determine the short- and long-term prognostic impact of emotional- and physical stress associated with TTC. Methods and results: Our institutional database constituted a collective of 84 patients diagnosed with TTC between 2003 and 2015. The patients were divided into two groups as per the presence of emotional stress (n=24, 21%) or physical stress (n=60, 52.6%). The endpoint was a composite of in-hospital events (thromboembolic events and life-threatening arrhythmias), myocardial infarction, all-cause of mortality, re-hospitalization due to heart failure, stroke, and recurrence of TTC. A Kaplan-Meier analysis indicated a significantly lower event-free survival rate over a mean follow-up of 5 years in the emotional group than the physical stress group (log-rank, p<0.01). Multivariate Cox regression analysis revealed only emotional stress (HR 0.4, 95% CI: 0.2-0.9, p<0.05) as a negative independent predictor of the primary endpoint. Conclusion: Rates of in-hospital events and short- as well as long-term events were significantly lower in TTC patients suffering from emotional stress as compared to patients with physical stress. 
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