Management of Takotsubo cardiomyopathy in non-academic hospitals in France: The Observational French SyndromEs of TakoTsubo (OFSETT) study

Background. - Takotsubo cardiomyopathy (TTC) is a rare condition characterized by a suddentemporary weakening of the heart. TTC can mimic acute myocardial infarction and is associatedwith a minimal release of myocardial biomarkers in the absence of obstructive coronary arterydisease.Aims. - To provide an extensive description of patients admitted to hospital for TTC throughoutFrance and to study the management and outcomes of these patients.Methods. - In 14 non-academic hospitals, we collected clinical, electrocardiographic, biolog-ical, psychological and therapeutic data in patients with a diagnosis of TTC according to theMayo Clinic criteria.Results. - Of 117 patients, 91.5% were women, mean ± SD age was 71.4 ± 12.1 years and theprevalence of risk factors was high (hypertension: 57.9%, dyslipidaemia: 33.0%, diabetes: 11.5%,obesity: 11.5%). The most common initial symptoms were chest pain (80.5%) and dyspnoea(24.1%). A triggering psychological event was detected in 64.3% of patients. ST-segment ele-vation was found in 41.7% of patients and T-wave inversion in 71.6%. Anterior leads weremost frequently associated with ST-segment elevation, whereas T-wave inversion was morecommonly associated with lateral leads, and Q-waves with septal leads. The ratio of peakB-type natriuretic peptide (BNP) or N-terminal prohormone BNP (NT-proBNP) level to peak tro-ponin level was 1.01. No deaths occurred during the hospital phase. After 1 year of follow-up,3 of 109 (2.8%) patients with available data died, including one cardiovascular death. Rehos-pitalizations occurred in 17.4% of patients: 2.8% due to acute heart failure and 14.7% due tonon-cardiovascular causes. There was no recurrence of TTC.Conclusions. - This observational study of TTC included primarily women with atheroscleroticrisk factors and mental stress. T-wave inversion was more common than ST-segment elevation.There were few adverse cardiovascular outcomes in these patients after 1-year follow-up.