Abstract 15976: Comparison of Patients With Variant and Typical Takotsubo Cardiomyopathy

Background: Variant, or reverse, Takotsubo cardiomyopathy (TTC) is defined by left ventricular basal and/or mid-ventricular systolic dysfunction with preserved apical function. This condition is increasingly recognized, yet there have been few studies comparing variant and typical TTC. This study aims to contrast the demographic features and clinical outcomes of patients with variant and typical TTC. Methods: All patients at a single academic medical center with a discharge diagnosis of Takotsubo syndrome [ICD-9-CM 429.83] from 2010-2014 were identified. Patients who met the Mayo Clinic criteria for TTC were included and were then grouped into typical or variant TTC categories based on wall motion abnormality patterns. Results: The initial query identified 275 patients with a discharge diagnosis of TTC, of which 145 (52.7%) met diagnostic criteria for TTC. Typical TTC was present in 125 patients (86.2%) and variant TTC in 20 patients (13.8%). The demographic and clinical characteristics of these groups are summarized in table 1. Variant TTC patients were more likely to be male and subject to a physically stressful trigger. Typical TTC patients had lower left ventricular ejection fraction, higher left ventricular end-diastolic pressure, and were more likely to be intubated. Cardiac biomarkers were not significantly different between groups. In-hospital mortality, length of hospital stay, TTC recurrence and follow-up LVEF were similar between groups. Conclusions: There are important differences between patients with variant and typical TTC. Variant TTC is not as strongly associated with female sex, it is more frequently preceded by a physical stressor, and it has a more benign presentation. Long term outcomes are favorable in patients with variant and typical TTC.