Abstract 237: Predictive role of thyroid in Takotsubo cardiomyopathy: A single center retrospective study
Background: Takotsubo cardiomyopathy (TC) is a transient systolic dysfunction of the apical and/or mid segments of the left ventricle that mimics myocardial infarction (MI) but in the absence of obstructive coronary artery disease. The exact etiology of TC is unclear. Few isolated case reports have described association of TC with hyperthyroid state. The exact association of thyroid status and TC has never been studied so far.
Method: This was a single center retrospective study. All the patients diagnosed with TC between January 2006 and December 2012 at our hospital were identified retrospectively. Mayo’s revised criteria for TC was used to confirm the diagnosis. Baseline paramenters including demographic profile, cardiac markers, thyroid studies, angiographic and echocardiographic findings were extracted and analysed using SPSSv19.0
Results: Seventy eight patient were identified as diagnosed with TC with 72 females (92.3%) and 6 males (7.6%) with mean age of 66.33 ± 13.37 years (range 23-91). Stressful event precipitating TC was identified only in 19 patients (24.36%) at the time of admission. Twenty seven patients (34.61%) had history of hypothyroidism and 25 patients (31.05%) were on levothyroxine replacement. Thyroid profile was available for 44 patients at the time of admission and 5 patients (11.36%) were found to be in a hyperthyroid state based on low TSH and/or high freeT4. During a mean follow up of 2.8 ± 1.5 years, 4 patients (5.13%) had episodes of recurrence.
Mean length of stay (mLOS) was 4.4 ± 3.9 days (Median 3 days, Range 1 - 23 days). Both TSH level and ejection fraction had significant independent negative correlation with mLOS (p <0.05).
Conclusion: Thyroid status/thyroid hormone replacement may have a significant role in the pathogenesis of TC. In this first retrospective study describing the association of TC with thyroid status, precipitating stress was identifiable in only 24% patients whereas 35% of the patients had a history of hypothyroidism with majority on levothyroxine replacement. Additionally, TSH level had an independent negative correlation with mLOS.
Author Disclosures: S. Aggarwal: None. R. Papani: None. V. Gupta: None.
- © 2014 by American Heart Association, Inc.