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急性冠状动脉综合征患者中Takotsubo心肌病的发病率:一项单中心回顾性分析

Incidence of Takotsubo cardiomyopathy in patients with acute coronary syndrome: a single center retrospective analysis.

作者信息

Poruban Tibor, Studencan Martin, Kirsch Peter, Novotny Robert

机构信息

Eastern Slovak Institute of Cardiovascular Diseases and School of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.

出版信息

Egypt Heart J. 2024 Aug 26;76(1):112. doi: 10.1186/s43044-024-00542-x.

DOI:10.1186/s43044-024-00542-x
PMID:39186244
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11347531/
Abstract

BACKGROUND

Takotsubo cardiomyopathy (TTC) is an acute and usually reversible condition that often mimics the course of acute coronary syndrome (ACS), making it particularly challenging to differentiate, especially in the initial phases. In this study, we retrospectively analyzed the incidence, clinical course, examination results, and in-hospital mortality of TTC in patients with ACS hospitalized at our cardiology center from January 2018 to October 2023.

RESULTS

During the study period, a total of 3835 selective coronary angiograms were urgently performed at our facility, with a diagnosis of TTC established in 52 (1.35%) patients, the majority of whom were females-48 (93%), with an average age of 64.2 ± 10.2 years. Stress-induced mechanisms were identified in 36 (69%) patients. The most common symptom was chest pain (86.5%). Electrocardiographic changes primarily included ST-segment elevations (61.6%) and depressions (14%). The average left ventricular ejection fraction was 45.1 ± 8.3 (33-57%), typically with an echocardiographic pattern of apical ballooning dysfunction followed by midventricular dyskinesia. In-hospital mortality was zero.

CONCLUSIONS

TTC is a reversible condition with a low incidence of complications. Its occurrence in our patient cohort is lower compared to international registries. However, as demonstrated in this study, it is associated with significant in-hospital morbidity.

摘要

背景

应激性心肌病(TTC)是一种急性且通常可逆的病症,常模仿急性冠状动脉综合征(ACS)的病程,这使得鉴别诊断颇具挑战性,尤其是在疾病初期。在本研究中,我们回顾性分析了2018年1月至2023年10月在我院心脏病中心住院的ACS患者中TTC的发病率、临床病程、检查结果及院内死亡率。

结果

在研究期间,我院共紧急进行了3835例选择性冠状动脉造影,其中52例(1.35%)患者被诊断为TTC,大多数为女性——48例(93%),平均年龄为64.2±10.2岁。36例(69%)患者被确定为应激诱导机制。最常见的症状是胸痛(86.5%)。心电图改变主要包括ST段抬高(61.6%)和压低(1,4%)。平均左心室射血分数为45.1±8.3(33 - 57%),典型的超声心动图表现为心尖部气球样功能障碍,随后是心室中部运动障碍。院内死亡率为零。

结论

TTC是一种可逆性病症,并发症发生率低。与国际登记数据相比,其在我们患者队列中的发生率较低。然而,如本研究所示,它与显著的院内发病率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d752/11347531/d6a09eb32a8f/43044_2024_542_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d752/11347531/d6a09eb32a8f/43044_2024_542_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d752/11347531/d6a09eb32a8f/43044_2024_542_Fig1_HTML.jpg

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Heart Fail Rev. 2024 Mar;29(2):497-510. doi: 10.1007/s10741-023-10381-8. Epub 2023 Dec 27.
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