Prospective comparison of temporal changes in myocardial function in women with Takotsubo versus anterior STEMI.

IF 3.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Research in Cardiology Pub Date : 2025-03-20 DOI:10.1007/s00392-025-02633-4

Sandeep Jha, Angela Poller, Aaron Shekka Espinosa, Linnea Molander, Valentyna Sevastianova, Rickard Zeijlon, Koen Simons, Emanuele Bobbio, Carlo Pirazzi, Andreas Martinsson, Tomas Mellberg, Thorsteinn Gudmundsson, Petronella Torild, Joakim Sundstrom, Erik Axel Andersson, Sigurdur Thorleifsson, Sabin Salahuddin, Ahmed Elmahdy, Tetiana Pylova, Araz Rawshani, Oskar Angeras, Truls Ramunddal, Kristofer Skoglund, Elmir Omerovic, Bjorn Redfors

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引用次数: 0

Abstract

Background: Takotsubo syndrome (TS) and STEMI with timely reperfusion are both characterized by reversible acute myocardial dysfunction, often referred to as myocardial stunning. The natural course of cardiac functional recovery is incompletely understood in TS and STEMI. The aim of this study was to prospectively compare changes in cardiac function over the acute and subacute phases in women with TS versus anterior STEMI.

Methods: The Stunning in Takotsubo versus Acute Myocardial Infarction (STAMI) study prospectively enrolled 61 women with TS and 41 women with STEMI. Echocardiography and blood sampling was performed within 4 h of admission and at 1, 2, 3, 7, 14, and 30 days after admission. The primary outcome was the proportion of reversible left ventricular akinesia (defined as extent of akinesia at baseline versus at 30 days) that resolved by 72 h. Secondary outcomes included LVEF, GLS, and TAPSE. Mixed effects linear regression or mixed effects tobit models with random intercepts were used to model echocardiographic parameters over time.

Results: At 72 h 40.4% [95% CI 30.1%, 50.1%] of the reversible akinesia had resolved in women with TS, versus 54.7% [95% CI 38.3%, 72.0%] for STEMI (difference 14.3% [95% CI - 4.6%, 34.3%]). Time-course of recovery of LVEF and GLS was also similar in TS and STEMI. TAPSE was reduced in TS but normal in STEMI; and recovered in a similar timeframe as the left ventricular indices. In both TS and STEMI, considerable recovery of cardiac function occurred after 7 days.

Conclusions: The time course of recovery of cardiac function is similar in TS and STEMI.

Trial registration: ClinicalTrials.gov ID NCT04448639, https://clinicaltrials.gov/study/NCT04448639 .

查看原文本刊更多论文

对患有 Takotsubo 和前 STEMI 的女性心肌功能的时间变化进行前瞻性比较。

背景：Takotsubo综合征（TS）和STEMI伴及时再灌注均以可逆性急性心肌功能障碍为特征，通常称为心肌休克。在TS和STEMI中，心功能恢复的自然过程尚不完全清楚。本研究的目的是前瞻性地比较TS和前路STEMI患者急性期和亚急性期心功能的变化。方法：Takotsubo与急性心肌梗死（STAMI）研究前瞻性纳入61名TS女性和41名STEMI女性。入院后4小时及入院后1、2、3、7、14、30天分别行超声心动图和采血。主要终点是72小时内消退的可逆性左心室运动障碍（定义为基线时与30天时的运动障碍程度）的比例。次要终点包括LVEF、GLS和TAPSE。混合效应线性回归或随机截距混合效应tobit模型用于模拟超声心动图参数随时间的变化。结果：在72小时时，40.4% （95% CI 30.1%, 50.1%）的TS患者可逆肌动症消退，而STEMI患者可逆肌动症消退的比例为54.7% (95% CI 38.3%, 72.0%)(差异为14.3% （95% CI - 4.6%, 34.3%）。TS和STEMI患者LVEF和GLS的恢复时间过程也相似。TAPSE在TS组降低，在STEMI组正常；恢复的时间和左心室指数差不多。在TS和STEMI中，心脏功能在7天后都有相当大的恢复。结论：TS与STEMI患者心功能恢复时间相近。试验注册：ClinicalTrials.gov ID NCT04448639, https://clinicaltrials.gov/study/NCT04448639。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Research in Cardiology 医学-心血管系统

CiteScore

11.40

自引率

4.00%

发文量

140

审稿时长

4-8 weeks

期刊介绍： Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.