Incidence and Clinical Impact of Recurrent Takotsubo Syndrome: Results From the GEIST Registry

Ibrahim El-Battrawy*, Francesco Santoro, Thomas Stiermaier, Christian Möller, Francesca Guastafierro, Giuseppina Novo, Salvatore Novo, Enrica Mariano, Francesco Romeo, Fabiana Romeo, Holger Thiele, Federico Guerra, Alessandro Capucci, Irene Giannini, Natale Daniele Brunetti, Ingo Eitel, Ibrahim Akin

*Corresponding author for this work


Background: Current literature only reports variable information from single-center studies on the recurrence rate, the complications, and the outcome of patients with Takotsubo syndrome (TTS) experiencing recurrent TTS. Therefore, a detailed description of clinical characteristics, predictors, and the prognostic impact of patients with TTS and recurrences in a multicenter registry is needed. Methods and Results: We analyzed 749 patients with TTS from 9 European centers being part of the international, multicenter GEIST (German Italian Stress Cardiomyopathy) Registry. Patients were divided into the recurrence group and the nonrecurrence group. The recurrence rate at a median follow-up of 830 days (interquartile range, 118–1701 days) was 4%. Most recurrences were documented in the first 5 years after the index TTS episode. Up to 2 TTS recurrences were documented in 2 of 30 patients (6%). A variable ballooning pattern (n=6, 0.8%) with, in particular, involvement of the right ventricular occurred in 3 cases (0.4%) at the recurrence event. Except for the higher presence of arterial hypertension (86.7% versus 68.3%; P=0.03) in the recurrence group, no other baseline characteristics were different between groups. Observation of TTS complications during follow-up, including stroke, thromboembolic events, in-hospital death, and cardiogenic shock, revealed no significant differences between groups (P>0.05), except the higher presence of pulmonary edema in the recurrence group versus the nonrecurrence group (13.3% versus 4.9%; P=0.04). Conclusions: The incidence of TTS recurrence is estimated to be 4% in this multicenter TTS registry. A variable TTS pattern at recurrence is common in up to 20% of recurrence cases.

Original languageEnglish
Article numbere010753
JournalJournal of the American Heart Association
Issue number9
Pages (from-to)e010753
Publication statusPublished - 07.05.2019

Research Areas and Centers

  • Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)


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