Giulia La Vecchia , Giulia Iannaccone , Michele Russo , Marco Giuseppe Del Buono , Vincenzo Scarica , Rosa Lillo , Massimiliano Camilli , Tommaso Sanna , Antonella Lombardo , Gaetano Antonio Lanza , Francesco Burzotta , Francesca Graziani , Antonio Maria Leone , Filippo Crea , Rocco A. Montone
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引用次数: 0
Abstract
Background
Takotsubo syndrome (TTS) is an acute condition characterized by a reversible left ventricular (LV) systolic dysfunction leading to serious in-hospital complications (IHC). The aim of our study is to investigate the prognostic impact of right ventricular-to-pulmonary artery (RV-PA) coupling in patients with TTS.
Methods
Consecutive TTS patients were prospectively enrolled. In all patients, standard and speckle tracking transthoracic echocardiography was performed within 48 h from hospital admission. RV function was evaluated by RV global longitudinal strain (RV-GLS) and RV free wall strain (RV-FWS) and RV-PA coupling was measured as the ratio of either tricuspid annular plane systolic excursion (TAPSE), RV-GLS or RV-FWS to pulmonary artery systolic pressure (PASP). Data about IHC (acute heart failure, life-threatening arrhythmias and death) were collected.
Results
A total of 80 patients were analyzed (71 ± 11 years, female 77.5 %) and IHC occurred in 33 (41 %). Patients who experienced IHC had lower LV ejection fraction (LVEF), lower left atrial (LA) reservoir strain, TAPSE/PASP, RV-FWS/PASP and RV-GLS/PASP and higher left atrial volume indexed (LAVi) values. At multivariate analysis, only LVEF (OR 0.913, 95 % CI [0.858–0.971], p = 0.004) was an independent predictor of IHC. Receiver operating characteristics (ROC) curve analysis showed an additional prognostic value of a combined model including RV-GLS/PASP and LVEF compared to LVEF alone in the prediction of IHC (AUC of 0.756 vs 0.736, differences between AUCs: 0.02 [p = 0.73]).
Conclusion
RV-PA coupling assessed by RV-GLS/PASP may help in identifying TTS patients at higher risk of cardiovascular complications with an additional prognostic value to LVEF alone.
期刊介绍：
The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers.
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