Bill Verena, El-Battrawy Ibrahim, Hoffmann Ursula, Haghi Darius, Kuschyk Jürgen, Borggrefe Martin, Akin Ibrahim
1 First Department of Medicine Cardiology, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany.
2 DZHK (German Center for Cardiovascular Research) Partner Site Mannheim, Mannheim, Germany.
Angiology. 2018 Feb;69(2):130-135. doi: 10.1177/0003319717718978. Epub 2017 Jul 10.
Takotsubo cardiomyopathy (TC) is a life-threatening syndrome with ambiguous pathophysiology. The interdependency between heart failure and kidney failure (KF) is well established, but the influence of KF on TC outcome is not known. This single-center cohort from January 2003 to September 2015 consisted of 114 consecutive patients with TC. They were divided into 2 groups according to the presence (n = 32, 29.6%) or absence (n = 76, 70.3%) of KF. The end point of this retrospective study was a composite of in-hospital events, all-cause mortality, rehospitalization due to heart failure, stroke, and recurrence of TC (mean follow-up: 5 years). Although there were no differences in baseline characteristics between patients with/without KF, we found a significantly higher mortality rate in those with KF, 1 (7.9% vs 21.8%, P < .05), 2 (11.8% vs 31.5%, P < .05), and 5 years (22.3% vs 43.7%, P < .05) after the index event. There were no differences in life-threatening arrhythmias, cardiogenic shock, cardiopulmonary resuscitation, and thromboembolic events in both groups at the index event. Patients with TC and KF have a much worse long-term prognosis. This is clinically relevant, but the mechanisms responsible remain to be determined.
应激性心肌病（TC）是一种病理生理机制尚不明确的危及生命的综合征。心力衰竭与肾衰竭（KF）之间的相互依存关系已得到充分证实，但KF对TC预后的影响尚不清楚。这项单中心队列研究纳入了2003年1月至2015年9月期间连续收治的114例TC患者。根据是否存在KF将他们分为两组，存在KF组（n = 32，29.6%）和不存在KF组（n = 76，70.3%）。这项回顾性研究的终点是院内事件、全因死亡率、因心力衰竭再次住院、中风和TC复发的综合指标（平均随访时间：5年）。尽管有/无KF患者的基线特征没有差异，但我们发现KF患者在首次事件后1年（7.9% 对21.8%，P <.05）、2年（11.8% 对31.5%，P <.05）和5年（22.3% 对43.7%，P <.05）的死亡率显著更高。在首次事件时，两组在危及生命的心律失常、心源性休克、心肺复苏和血栓栓塞事件方面没有差异。合并KF的TC患者长期预后更差。这具有临床相关性，但其潜在机制仍有待确定。
