Nishimura Yu-Ki, Komatsu Junya, Sugane Hiroki, Hosoda Hayato, Imai Ryu-Ichiro, Nakaoka Yoko, Nishida Koji, Seki Shu-Ichi, Kubo Toru, Kitaoka Hiroaki, Kubokawa Sho-Ichi, Kawai Kazuya, Hamashige Naohisa, Doi Yoshinori
Department of Cardiology, Chikamori Hospital Kochi Japan.
Department of Cardiology and Aging Science, Kochi Medial School Kochi Japan.
Circ Rep. 2024 May 25;6(6):201-208. doi: 10.1253/circrep.CR-23-0093. eCollection 2024 Jun 10.
Takotsubo syndrome (TTS) in male patients is under-studied, particularly in the older population. From 226 patients with TTS, 44 older male patients (prevalence rate: 19.5%, age: median 77 years) were compared with 182 older female patients (prevalence rate: 80.5%, age: median 80 years). Emotional triggers of TTS were less frequent (2% vs. 19%; P=0.007), whereas physical triggers were more frequent (75% vs. 58%; P=0.040) in older men than in women. Among physical triggers, serious respiratory infection was more common in older men than in women. As initial clues to the diagnosis, ECG T-wave inversion was more frequent (48% vs. 29%; P=0.018) and chest pain and/or dyspnea were less common (23% vs. 38%; P=0.050) in older men than in women. In total, 14 patients (6%) had cardiogenic shock and 41 (18%) had severe heart failure as complications, although there were no significant differences in the frequency of these complications between older men and women. Although cardiac death occurred in 3 female patients (1%) and noncardiac death in 3 male and 5 female patients (4%), there were no significant differences in death rate between older men and women. Emotional triggers of TTS were extremely infrequent whereas physical triggers were common in older men. Although severe heart failure was common, there were no significant differences in the frequency of complications and in-hospital deaths between older men and women.
男性患者的应激性心肌病（TTS）研究较少，尤其是在老年人群中。在226例TTS患者中，将44例老年男性患者（患病率：19.5%，年龄：中位数77岁）与182例老年女性患者（患病率：80.5%，年龄：中位数80岁）进行比较。与女性相比，老年男性TTS的情绪诱发因素较少见（2%对19%；P = 0.007），而身体诱发因素更常见（75%对58%；P = 0.040）。在身体诱发因素中，严重呼吸道感染在老年男性中比在女性中更常见。作为诊断的初始线索，老年男性心电图T波倒置更常见（48%对29%；P = 0.018），胸痛和/或呼吸困难则较少见（23%对38%；P = 0.050）。共有14例患者（6%）发生心源性休克，41例患者（18%）发生严重心力衰竭作为并发症，尽管这些并发症的发生率在老年男性和女性之间没有显著差异。虽然3例女性患者（1%）发生心源性死亡，3例男性和5例女性患者（4%）发生非心源性死亡，但老年男性和女性的死亡率没有显著差异。TTS的情绪诱发因素极为罕见，而身体诱发因素在老年男性中很常见。虽然严重心力衰竭很常见，但老年男性和女性在并发症发生率和住院死亡率方面没有显著差异。
