Abstract | INTRODUCTION: TakoTsubo cardiomyopathy is a complex pathological condition considered as a cardiomyopathy with multifactorial aetiology, where the decreased level of the estrogen in postmenopausal women contributes as an important risk factor. ----- AIM: To analyse risk factors for the development of TakoTsubo cardiomyopathy in our patient population and test if they are related with different myocardial damage severity which can be defined by blood level of troponin and N-terminal pro B-type natriuretic peptide as well as changes in left ventricular ejection fraction. ----- MATERIALS AND METHODS: In this retrospective study we included 49 patients that were consecutively hospitalized in the Department of cardiovascular diseases, University hospital centre Zagreb with the diagnosis of TakoTsubo cardiomyopathy in the period from 2007 till 2017. Statistical analysis was performed using SPSS statistical software. Categorical data are presented as absolute and relative frequencies, continuous variables as median with range. ----- RESULTS: The analysis showed that 35 of 49 patients (70%) with the diagnosis of TakoTsubo cardiomyopathy were postmenopausal women. In our patients, 20,4% had an intracranial pathology. The average age in patients with TakoTsubo cardiomyopathy was 67,65 ± 12,62 years and there was no statistically significant difference in age between males and females (p=0,710). The average ejection fraction was 46% ± 11% and there was no statistically significant difference in EF between postmenopausal women and other patients (p=0,237). The average level of troponin was 593,28 ± 306,84 ng/L. There was no statistically significant difference in troponin level between postmenopausal females and other patients (p=0,278). There was a moderate negative correlation between troponin level and EF (p=0,021, r=-0,348). There was not any significant difference in the prevalence of intracranial pathology between postmenopausal and other patients (p=0,087). Mean serum NT-proBNP level was 2845 ± 1300,43 pg/mL with no significant difference between postmenopausal women and other patients (p=0,374). ----- CONCLUSION: The majority of patients with TakoTsubo cardiomyopathy in our population are postmenopausal women. However, there is no difference in the level of serum troponin, NT-proBNP as well as EF between postmenopausal women and other patients with this diagnosis. Although it increases the risk for the development, it seems that menopause doesn’t affect the level of myocardial damage in TakoTsubo cardiomyopathy. |
Abstract (croatian) | UVOD: Takotsubo kardiomiopatija je kompleksno patološko stanje multifaktorijalne etiologije, pri čemu se smanjena razina estrogena u serumu kod žena u postmenopauzi smatra važnim rizičnim čimbenikom. ----- CILJ: Analizirati u našoj populaciji pacijenata različite rizične čimbenike za razvoj TakoTsubo kardiomiopatije i ispitati jesu li isti povezani sa različitim stupnjem oštećenja miokarda definiranim razinom srčanog troponina i N-terminalnog proB-tipa natriuretskog peptida u serumu bolesnika, te iznosom istisne frakcije (EF, engl. ejection fraction) lijeve klijetke. ----- MATERIJALI I METODE: U ovoj retrospektivnoj studiji smo uključili 49 pacijenata koji su bili za redom hospitalizirani u Klinici za bolesti srca i krvnih žila Kliničkog bolničkog centra Zagreb zbog dijagnoze TakoTsubo kardiomiopatije u periodu od 2007. do 2017. godine. Statistička analiza je urađena koristeći SPSS statistički program. Kategorički podaci su prikazani kao apsolutna i relativna učestalost, a kontinuirane varijable kao medijan s rasponom. ----- REZULTATI: Analiza je pokazala da su 35 od 49 pacijenata (70%) s dijagnozom TakoTsubo kardiomiopatije bile žene u postmenopauzi. Kod naših pacijenata, njih 20,4% je imalo neku intrakranijalnu patologiju. Prosjek dobi kod pacijenata sa TakoTsubo kardiomiopatijom je bio 67,65 ± 12,62 i nije bilo statističke značajne razlike u dobi između muškaraca i žena. (p=0,710). Prosječna istisna frakcija je bila 46% ± 11% i nije bilo statističke značajne razlike između postmenopauzalnih žena i ostalih pacjenata (p=0,237). Prosječna razina troponina je bila 593,28 ± 306,84 ng/L. Nije bilo statističke značajne razlike u troponinu između postmenopauzalnih žena i ostalih pacjenata (p=0,278). Našli smo umjerenu negativnu povezanost između istisne frakcije lijeve klijetke i razine srčanog troponina u serumu (p=0,021, r=-0,348). Nije bilo nikakve statističke razlike u pojavnosti intrakranijalne patologije između postmenopauzalnih žena i ostalih pacijenata (p=0,087). Srednja serumska vrijednost NT-proBNP-a iznosila je 2845±1300,43 pg/mL, bez značajne razlike između postmenopauzalnih žena i ostalih pacijenata s ovom dijagnozom (p=0,374). ----- ZAKLJUČAK: Većina pacijenata s dijagnozom TakoTsubo kardiomiopatije u našoj bolesničkoj populaciji bile su žene u postmenopauzi. Nismo našli razliku u razini srčanog troponina i NT-proBNP u serumu, kao i istisnoj frakciji lijeve klijetke između postmenopauzalnih žena i ostalih pacijenata s ovom dijagnozom. Dakle, iako menopauza povećava rizik za razvoj TakoTusbo kardiomiopatije, čini se da ista ne utječe na težinu oštećenja miokarda. |