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European Journal of Heart Failure 2008 10(10):1015-1019; doi:10.1016/j.ejheart.2008.07.008
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© 2008 European Society of Cardiology

Long-term prognosis of the transient left ventricular dysfunction syndrome (Tako-Tsubo cardiomyopathy): Focus on malignancies

Christof Burgdorf*, Volkhard Kurowski, Hendrik Bonnemeier, Heribert Schunkert and Peter Walter Radke

Department of Internal Medicine II, University Hospital Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany

* Corresponding author. Tel.: +49 451 500 2421; fax: +49 451 500 2363. E-mail address: christof.burgdorf{at}uk-sh.de (C. Burgdorf).


  Abstract

Background: The pathophysiology and long-term prognosis of the transient left ventricular dysfunction syndrome (LVDS, Tako-Tsubo cardiomyopathy) is largely unknown.

Aims: To investigate the prevalence of malignancies and long-term mortality in patients with LVDS.

Methods and results: Fifty patients with LVDS (47 females and 3 men, age 70±10 years) and 50 age- and gender-matched control patients with acute anterior myocardial infarction (MI) were evaluated. Nine patients (18%) with LVDS and 3 patients (6%) with MI had a previous history of malignancy at the time of the index event. On follow-up (2.9±1.6 years), 7 malignancies were newly diagnosed in the LVDS cohort whereas no new case of malignancy was found in the control group (p=0.01, odds ratio 16.95, 95% confidence interval [CI] 1.93–304.60). Overall mortality during follow-up did not differ significantly between both groups (hazard ratio 1.44 for death in LVDS patients, 95% CI 0.52–3.95, p=0.49); however, of those patients who died, cardiac deaths were more frequent in patients with MI (100% versus 11%in patients with LVDS, p<0.001).

Conclusions: Our data suggest an association of LVDS with malignancies, potentially as a result of paraneoplastic phenomena. Long-term prognosis of patients with LVDS is no better than in patients with acute MI.

Key Words: Left ventricular dysfunction syndrome • Tako-Tsubo cardiomyopathy • Malignancy • Prevalence • Mortality • Myocardial infarction

Received April 10, 2008; Revised June 3, 2008; Accepted July 17, 2008


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