Impact of Right Ventricular Impairment on Morbidity and Mortality in Takotsubo Syndrome-A Meta-Analysis of Observational Trials

Authors

Suchith Shetty, Department of Cardiology, University of Iowa Health Care, Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242, USA. suchith-shetty@uiowa.edu.
Aaqib H. Malik, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
Manju Bengaluru Jayanna, Department of Cardiology, Lankenau Institute for Medical Research, Philadelphia, PA, USA.
Wilbert S. Aronow, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
Alexandros Briasoulis, Department of Cardiology, University of Iowa Health Care, Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
Kan Liu, Department of Cardiology, University of Iowa Health Care, Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242, USA.

Author Type(s)

Faculty

DOI

10.1007/s10741-020-09981-5

Journal Title

Heart Failure Reviews

First Page

263

Last Page

270

Document Type

Article

Publication Date

1-1-2022

Department

Medicine

Keywords

In-hospital mortality, Long-term mortality, Right ventricular impairment, Takotsubo cardiomyopathy

Disciplines

Medicine and Health Sciences

Abstract

The impact of right ventricular impairment (RVI) on the morbidity and mortality of patients with Takotsubo syndrome (TTS) is well-debated. We conducted a meta-analysis to evaluate the mortality and morbidity risk associated with RVI compared with those without RVI in patients with TTS. A comprehensive search was performed in PubMed and Embase from inception to April 19, 2019. Our primary outcome of interest was in-hospital and long-term mortality. Other outcomes of interest were acute heart failure, left ventricular systolic function, tricuspid and mitral regurgitation, and length of hospital stay (LOS). We are reporting our outcomes as a cumulative odds ratio (OR). After an initial search, 10 studies with 1210 subjects were included in the quantitative analysis. Mean follow-up was 31 months. The odds of in-hospital and long-term mortality in TTS patients with and without RVI were not significantly different (p = 0.13 and 0.40). In TTS patients without RVI, the odds of acute heart failure, and mitral and tricuspid regurgitation were significantly lower at an OR of 0.26 (p < 0.0001), 0.40 (p = 0.0001), and 0.52 (p = 0.02) respectively. TTS patients with RVI had significantly lower mean LVEF (34% vs 41%, p = 0.03) and numerically higher mean LOS (9.5 days vs 7.6 days, p = 0.52) compared with those without RVI. The presence of RVI represents a severe form of TTS disease spectrum, characterized by severely reduced LVEF, higher incidence of MR and presence of TR. Although there was a trend toward increased in-hospital and long-term mortality, RVI in TTS does not portend worse survival.

Recommended Citation

Shetty, S., Malik, A. H., Jayanna, M. B., Aronow, W. S., Briasoulis, A., & Liu, K. (2022). Impact of Right Ventricular Impairment on Morbidity and Mortality in Takotsubo Syndrome-A Meta-Analysis of Observational Trials. Heart Failure Reviews, 27 (1), 263-270. https://doi.org/10.1007/s10741-020-09981-5