Right Ventricular Failure in Patients Presenting With Takotsubo Cardiomyopathy
Author Type(s)
Faculty, Resident/Fellow
Document Type
Abstract
Publication Date
2022
DOI
10.1016/j.jacc.2022.08.405
Journal Title
Journal of the American College of Cardiology
Department
Medicine
Abstract
Background: There are very limited data reporting outcomes of takotsubo syndrome (TTS) with right heart failure (RHF). We utilized a nationwide cohort to identify differential outcomes in patients presenting with takotsubo syndrome with and without RHF. Methods: Data from the 2018-19 National Inpatient Sample were collected in patients presenting with TTS. International Classification of Diseases codes were further used to identify patients with RHF. The primary outcome of interest was inpatient mortality. Survey-specific techniques were used to perform all the analyses in STATA 16.0. Results: A total of 81,230 patients were identified with TTS. Among them, 0.2% (n = 155) had concomitant diagnosis of RHF. Mean age was similar in both groups at 67 years. Overall, RHF was more seen in males (35.5% vs 17.4%; P < 0.01). Patients with RHF were more likely to have chronic kidney disease (16.1% vs 7.7%; P < 0.05). Other comorbidities were numerically higher but not statistically significant. In an unadjusted model, patients with RHF were 4 times more likely to die (6.4% vs 25.8%; P < 0.01). They were more likely to have cardiogenic shock, cardiac arrest, mechanical circulatory support, vasopressor use, and ventilator use (P < 0.05 for all). In a multivariable logistic regression adjusted model, RHF remained significantly associated with a higher mortality adjusted OR of 3.88 (95% CI: 1.51-10.0; P < 0.001). In the subgroup analysis, being male was significantly associated with a higher likelihood of getting RHF (adjusted OR: 2.63; 95% CI: 1.17-5.88; P < 0.01). These patients were at a higher risk of in-hospital mortality with adjusted OR of 1.49 (95% CI:.27-1.75; P < 0.01). Conclusion: Patients with TTS are particularly prone to higher mortality and in-hospital mortality with concomitant RHF. Early mechanical support is needed, and careful examination of the right ventricle is required to identify a high-risk cohort. Categories: STRUCTURAL: Heart Failure
Recommended Citation
Malik, A., Goel, A., Gupta, R., Bandyopadhyay, D., Shetty, S., hajra, A., Aronow, W., & Ahmad, H. (2022). Right Ventricular Failure in Patients Presenting With Takotsubo Cardiomyopathy. Journal of the American College of Cardiology, 80 (12), B139-B140. https://doi.org/10.1016/j.jacc.2022.08.405
