Department of Internal Medicine, Hôpital Avicenne, AP-HP, Bobigny, France.
Department of Internal Medicine, Hôpital Cochin, AP-HP, Paris, France.
Autoimmun Rev. 2024 Feb;23(2):103483. doi: 10.1016/j.autrev.2023.103483. Epub 2023 Nov 26.
Describe the characteristics of patients presenting with TTS during the course of a broad spectrum of systemic diseases, in comparison to classic TTS.
French multicenter retrospective case-control study completed by a literature review.
19 new cases were included in the study. The literature review identified 25 previously published cases. Among the 44 patients, 41 were females, with a median age of 67 years. The main underlying systemic diseases were systemic lupus erythematosus for seven, rheumatoid arthritis for six and primary Sjögren's syndrome for five. A TTS trigger was found in 34 cases, including a systemic disease flare-up in 28. The flare-up was treated in 15 cases, mainly with corticosteroids. One patient died during the episode, unrelated to the TTS. With a median follow-up of 24 months, all patients had recovered a normal LVEF, one had presented a recurrence of TTS, and none had died of a cardiac cause. Finally, the 19 new patients were compared with 19 classic TTS. The disease characteristics were extremely similar, with no significant difference in terms of clinical, electrocardiographic, biological and echocardiographic presentation.
A broad spectrum of systemic diseases may rarely be accompanied by TTS, particularly during disease flare-ups. Although uncommon, TTS should be borne in mind in the presence of any cardiac symptomatology during the course of a systemic disease. Compared with classic TTS, their clinical, biological and echographic presentation is unremarkable. The prognosis for TTS appears to be good, with the consistent recovery of LVEF and no cardiac-related deaths.
描述在广泛的系统性疾病过程中出现 TTS 的患者的特征，与经典 TTS 相比。
通过文献回顾完成的法国多中心回顾性病例对照研究。
研究纳入了 19 例新病例。文献回顾共确定了 25 例先前发表的病例。在 44 例患者中，41 例为女性，中位年龄为 67 岁。主要潜在的系统性疾病包括系统性红斑狼疮 7 例、类风湿关节炎 6 例和原发性干燥综合征 5 例。在 34 例患者中发现 TTS 诱因，其中 28 例为系统性疾病发作。在 15 例患者中治疗了发作，主要使用皮质类固醇。1 例患者在发作期间死亡，与 TTS 无关。中位随访 24 个月后，所有患者的 LVEF 均恢复正常，1 例出现 TTS 复发，无患者死于心脏原因。最后，将 19 例新患者与 19 例经典 TTS 进行比较。疾病特征极为相似，在临床表现、心电图、生物学和超声心动图表现方面无显著差异。
广泛的系统性疾病可能很少伴有 TTS，尤其是在疾病发作期间。尽管不常见，但在系统性疾病过程中出现任何心脏症状时，都应考虑到 TTS。与经典 TTS 相比，其临床、生物学和超声心动图表现无明显差异。TTS 的预后似乎良好，LVEF 持续恢复，无心脏相关死亡。
