Yayehd Komlavi, N'da N'kenon W, Belle Loïc, Bataille Vincent, Hanssen Michel, Leddet Pierre, Aupetit Jean-François, Commeau Philippe, Filippi Emmanuelle, Georges Jean-Louis, Albert Franck, Rangé Grégoire, Meimoun Patrick, Marcaggi Xavier, Baleynaud Serge, Nallet Olivier, Dibie Alain, Barnay Claude, Jouve Bernard, Legrand Maud, Cattan Simon, Mulak Geneviève, Simon Tabassome, Danchin Nicolas, Dujardin Jean-Jacques
Department of Cardiology, Campus University Teaching Hospital, Lomé, Togo.
Department of Cardiology, Annecy Hospital, 74000 Annecy, France.
Arch Cardiovasc Dis. 2016 Jan;109(1):4-12. doi: 10.1016/j.acvd.2015.08.004. Epub 2015 Oct 23.
Takotsubo cardiomyopathy (TTC) is a rare condition characterized by a sudden temporary weakening of the heart. TTC can mimic acute myocardial infarction and is associated with a minimal release of myocardial biomarkers in the absence of obstructive coronary artery disease.
To provide an extensive description of patients admitted to hospital for TTC throughout France and to study the management and outcomes of these patients.
In 14 non-academic hospitals, we collected clinical, electrocardiographic, biological, psychological and therapeutic data in patients with a diagnosis of TTC according to the Mayo Clinic criteria.
Of 117 patients, 91.5% were women, mean ± SD age was 71.4 ± 12.1 years and the prevalence of risk factors was high (hypertension: 57.9%, dyslipidaemia: 33.0%, diabetes: 11.5%, obesity: 11.5%). The most common initial symptoms were chest pain (80.5%) and dyspnoea (24.1%). A triggering psychological event was detected in 64.3% of patients. ST-segment elevation was found in 41.7% of patients and T-wave inversion in 71.6%. Anterior leads were most frequently associated with ST-segment elevation, whereas T-wave inversion was more commonly associated with lateral leads, and Q-waves with septal leads. The ratio of peak B-type natriuretic peptide (BNP) or N-terminal prohormone BNP (NT-proBNP) level to peak troponin level was 1.01. No deaths occurred during the hospital phase. After 1 year of follow-up, 3 of 109 (2.8%) patients with available data died, including one cardiovascular death. Rehospitalizations occurred in 17.4% of patients: 2.8% due to acute heart failure and 14.7% due to non-cardiovascular causes. There was no recurrence of TTC.
This observational study of TTC included primarily women with atherosclerotic risk factors and mental stress. T-wave inversion was more common than ST-segment elevation. There were few adverse cardiovascular outcomes in these patients after 1-year follow-up.
应激性心肌病（TTC）是一种罕见疾病，其特征为心脏突然出现暂时性功能减弱。TTC可酷似急性心肌梗死，且在无阻塞性冠状动脉疾病的情况下，心肌生物标志物释放极少。
全面描述法国各地因TTC入院患者的情况，并研究这些患者的治疗及预后。
在14家非学术性医院，我们根据梅奥诊所标准收集了诊断为TTC患者的临床、心电图、生物学、心理学及治疗数据。
117例患者中，91.5%为女性，平均年龄±标准差为71.4±12.1岁，危险因素患病率较高（高血压：57.9%，血脂异常：33.0%，糖尿病：11.5%，肥胖：11.5%）。最常见的初始症状为胸痛（80.5%）和呼吸困难（24.1%）。64.3%的患者检测到诱发心理事件。41.7%的患者出现ST段抬高，71.6%的患者出现T波倒置。前壁导联最常与ST段抬高相关，而T波倒置更常与侧壁导联相关，Q波与间隔导联相关。B型利钠肽（BNP）或N末端脑钠肽前体（NT-proBNP）峰值水平与肌钙蛋白峰值水平之比为1.01。住院期间无死亡病例。随访1年后，109例有可用数据的患者中有3例（2.8%）死亡，其中1例为心血管死亡。17.4%的患者再次住院：2.8%因急性心力衰竭，14.7%因非心血管原因。未出现TTC复发。
这项关于TTC的观察性研究主要纳入了有动脉粥样硬化危险因素和精神压力的女性。T波倒置比ST段抬高更常见。这些患者随访1年后心血管不良事件较少。
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