AUTHOR=Giannakopoulos Konstantinos , El-Battrawy Ibrahim , Schramm Katja , Ansari Uzair , Hoffmann Ursula , Borggrefe Martin , Akin Ibrahim 

TITLE=Comparison and Outcome Analysis of Patients with Takotsubo Cardiomyopathy Triggered by Emotional Stress or Physical Stress

JOURNAL=Frontiers in Psychology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2017.00527

DOI=10.3389/fpsyg.2017.00527

ISSN=1664-1078

ABSTRACT=<p><bold>Background:</bold> Previous studies revealed that takotsubo cardiomyopathy (TTC) is triggered by physical and emotional stresses. This study was performed to determine the short- and long-term prognostic impact of emotional- and physical stress associated with TTC.</p><p><bold>Methods and results:</bold> Our institutional database constituted a collective of 84 patients diagnosed with TTC between 2003 and 2015. The patients were divided into two groups as per the presence of emotional stress (<italic>n</italic> = 24, 21%) or physical stress (<italic>n</italic> = 60, 52.6%). The endpoint was a composite of in-hospital events (thromboembolic events and life-threatening arrhythmias), myocardial infarction, all-cause of mortality, re-hospitalization due to heart failure, stroke, and recurrence of TTC. A Kaplan–Meier analysis indicated a significantly lower event-free survival rate over a mean follow-up of 5 years in the emotional group than the physical stress group (log-rank, <italic>p</italic> &lt; 0.01). Multivariate Cox regression analysis revealed only emotional stress (HR 0.4, 95% CI: 0.2–0.9, <italic>p</italic> &lt; 0.05) as a negative independent predictor of the primary endpoint.</p><p><bold>Conclusion:</bold> Rates of in-hospital events and short- as well as long-term events were significantly lower in TTC patients suffering from emotional stress as compared to patients with physical stress.</p>