El-Battrawy Ibrahim, Ansari Uzair, Behnes Michael, Hillenbrand Dennis, Schramm Katja, Haghi Darius, Hoffmann Ursula, Papavassiliu Theano, Elmas Elif, Fastner Christian, Becher Tobias, Baumann Stefan, Dösch Christina, Heggemann Felix, Kuschyk Jürgen, Borggrefe Martin, Akin Ibrahim
First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany; DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany.
First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
J Geriatr Cardiol. 2016 Nov;13(11):888-893. doi: 10.11909/j.issn.1671-5411.2016.11.002.
Recurrence of takotsubo cardiomyopathy (TTC) is a well-known complication. However, current literature lists only a few isolated cases. We aimed to determine the incidence and clinical significance of recurrent TTC.
METHODS & RESULTS: Our institutional database constituted a collective of 114 patients diagnosed with TTC since 2003. Close follow-up of these patients revealed a recurrence of TTC in seven of these (6.1%). The time interval between the index event and its recurrence varied between six months and six years. Arterial hypertension was more revealed in the recurrence group of TTC compared to non-recurrence group, ( = 0.02). Chronic obstructive pulmonary disease and/or asthma was more diagnosed in the recurrence group, ( = 0.04). Clinical events like right ventricular involvement, TTC related complications such as life-threatening arrhythmias, pulmonary congestion and in hospital death were observed more frequently in the recurrent episode. Over a mean follow-up of one year the mortality rate was similar in both groups.
Recurrence of TTC within six years after index event is not an uncommon phenomenon. In the event of right ventricular involvement in the relapse phase, it might be associated with a higher complication rate. TTC recurrence should be the first differential diagnosis in patients with a past history of TTC.
应激性心肌病（TTC）复发是一种众所周知的并发症。然而，目前的文献仅列举了少数孤立病例。我们旨在确定复发性TTC的发生率及其临床意义。
我们机构的数据库收集了自2003年以来诊断为TTC的114例患者。对这些患者的密切随访发现其中7例（6.1%）出现了TTC复发。首次发病事件与其复发之间的时间间隔在6个月至6年之间。与非复发组相比，TTC复发组中动脉高血压更为常见（P = 0.02）。复发组中慢性阻塞性肺疾病和/或哮喘的诊断更为多见（P = 0.04）。在复发发作中，右心室受累、危及生命的心律失常、肺充血和住院死亡等TTC相关并发症等临床事件更为频繁地出现。在平均一年的随访中，两组的死亡率相似。
首次发病事件后6年内TTC复发并非罕见现象。在复发阶段出现右心室受累时，可能与较高的并发症发生率相关。对于有TTC既往史的患者，TTC复发应作为首要的鉴别诊断。
