Abstract 15163: Role of Thyroid in Takotsubo Cardiomyopathy: A Multicenter Retrospective Observational Study

• Published in: Circulation (New York, N.Y.) Vol. 140; no. Suppl_1 Suppl 1; p. A15163
• Main Authors: Bath, Anandbir S, Mahabir, Chetaj, Aggarwal, Sourabh, Wadhwani, Lalit, Morton, Jacob, Hernandez, Alysa, Pavlides, Gregory S, Gupta, Vishal, Kalavakunta, Jagadeesh K
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 19-11-2019
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.15163

IntroductionTakotsubo cardiomyopathy (TC) is a reversible transient systolic dysfunction of the apical and/or mid segments of the left ventricle in non-coronary distribution that clinically mimics myocardial infarction but in the absence of angiographic evidence of obstructive coronary artery disease. The exact etiology of TC is unclear. Few case reports/series have described an association of TC with the hyperthyroid state but multicenter clinical studies are still limited.MethodsThis was a multicenter retrospective observational study. All the patients diagnosed with TC between January 2006 and December 2017 were identified retrospectively. Mayo’s revised criteria for TC was used to confirm the diagnosis. Baseline parameters including demographic profile, length of stay, recurrent admissions, thyroid studies, angiographic and echocardiographic findings were extracted and analyzed.Results187 patients were identified as diagnosed with TC with 156 females (83%) and 31 males (17%) with a mean age of 65.3 ± 12 years (range 17-88). Mean length of stay during index admission was 4.9 ± 4.0 days with a median of 4 days. 12 patients (6.4%) required hemodynamic support with vasopressors and/or a balloon pump. During a mean follow up of 38 months, 17 patients (9.1%) had episodes of recurrent TC. Mean left ventricle ejection fraction was noted to improve from 36±12% at the time of index admission to 54±10% on follow up. Stressful event (emotional and/or physical) precipitating TC was identified only in 46 patients (24.6%) at the time of admission. History of thyroid abnormalities was present in 53 patients (28.3%) and 51 of them were on home thyroxine replacement therapy.ConclusionsThis is the largest retrospective study describing the association of TC with thyroid status. Precipitating emotional/physical stress was identifiable in only 24.6% of cases. A significantly high proportion of patients (28.3%) had a history of thyroid abnormalities when compared to the known prevalence of thyroid abnormalities in population with similar demographics. Thyroid abnormalities may have a significant role in the pathogenesis of TC. Larger studies are needed to define the association.