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    • Neurological Disorders in Takotsubo Syndrome: Clinical Phenotypes and Outcomes.

    JOURNAL OF THE AMERICAN HEART ASSOCIATION（2024）

    Univ Foggia | Univ San Carlos | Inst Cardiol | Univ Hosp | Univ Mannheim | Marche Polytech Univ | Department of Health Promotion | Univ Roma Tor Vergata | Sapienza Univ Rome | San Paolo Hosp | Univ Cagliari | Univ Hosp Arnau de Vilanova | Hosp Orense | Univ Hosp Salamanca | Hosp Son Espases | Hosp La Princesa | Bonomo Hosp | Univ Leipzig | Univ Heart Ctr Lubeck

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    Abstract
    Background Neurological disorders as a risk factor for Takotsubo syndrome (TTS) are not well characterized. The aim of the study was to evaluate TTS‐associated neurological phenotypes and outcome. Methods and Results Patients with TTS enrolled in the international multicenter GEIST (German Italian Spanish Takotsubo) registry were analyzed. Prevalence, clinical characteristics, and short‐ and long‐term outcomes of patients with TTS were recorded. A subgroup analysis of the 5 most represented neurological disorders was performed. In total, 400 (17%) of 2301 patients had neurological disorders. The most represented neurological conditions were previous cerebrovascular events (39%), followed by neurodegenerative disorders (30.7%), migraine (10%), epilepsy (9.5%), and brain tumors (5%). During hospitalization, patients with neurological disorders had longer in‐hospital stay (8 [interquartile range, 5–12] versus 6 [interquartile range, 5–9] days; P<0.01) and more often experienced in‐hospital complications (27% versus 16%; P=0.01) mainly driven by cardiogenic shock and in‐hospital death (12% versus 7.6% and 6.5% versus 2.8%, respectively; both P<0.01). Survival analysis showed a higher mortality rate in neurological patients both at 60 days and long‐term (8.8% versus 3.4% and 23.5% versus 10.1%, respectively; both P<0.01). Neurological disorder was an independent predictor of both the 60‐day and long‐term mortality rate (odds ratio, 1.78 [95% CI, 1.07–2.97]; P=0.02; hazard ratio, 1.72 [95% CI, 1.33–2.22]; both P<0.001). Patients with neurodegenerative disorders had the worst prognosis among the neurological disease subgroups, whereas patients with TTS with migraine had a favorable prognosis (long‐term mortality rates, 29.2% and 9.7%, respectively). Conclusions Neurological disorders identify a high‐risk TTS subgroup for enhanced short‐ and long‐term mortality rate. Careful recognition of neurological disorders and phenotype is therefore needed.
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    neurological disease,risk stratification,Takotsubo syndrome
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    【要点】：研究评估了神经性疾病与应激性心肌病（Takotsubo综合征，TTS）之间的联系，发现神经性疾病是TTS患者短期和长期死亡率的独立预测因子。
    

    【方法】：通过分析国际多中心GEIST（德国-意大利-西班牙Takotsubo）登记的TTS患者数据，记录了神经性疾病的患病率、临床特征及短期和长期预后。
    

    【实验】：在2301名TTS患者中，对有神经性疾病的400名患者进行了亚组分析，使用的数据集为GEIST registry。结果显示，有神经性疾病的患者住院时间更长，住院并发症更多，且60天及长期死亡率均高于无神经性疾病的患者。