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Pediatric takotsubo cardiomyopathy: A review and insights from a National Multicentric Registry

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A Correction to this article was published on 16 April 2024

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Abstract

Takotsubo syndrome (TTS) in the pediatric population is an infrequent but relevant cause of morbidity and mortality, with limited studies addressing its clinical course and prognosis. We aimed to analyze the clinical features and prognosis of pediatric TTS in a nation-wide multicenter registry and considering the published literature. We included a total of 54 patients from 4 different hospitals in Spain, as well as pediatric TTS patients from the published literature. Comparisons between groups were performed in order to assess for statistically and clinically relevant prognostic differences between pediatric and adult population features. Patients with pediatric TTS are more commonly male and exhibit a higher prevalence of physical triggers. The left ventricular ejection fraction (LVEF) was significantly lower in the pediatric population (30.5 + 10.4 vs 36.9 + 16.9, p < 0.05), resulting in more than fivefold rates of cardiogenic shock on admission compared to the general adult TTS population (Killip IV 74.1% vs 10.5%, p < 0.001) with similar rates of death and recurrence between groups. TTS in the pediatric population presents a distinctive clinical profile, with higher prevalence of atypical symptoms and physical triggers, as well as higher rates of cardiogenic shock on admission and similar mortality and recurrence rates than those of the adult population. This study provides valuable insights into understanding pediatric TTS and underscores the necessity for further research in this age group.

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Funding

No funding was required for the preparation of this manuscript. The web page from the RETAKO registry has been funded with the help of a non-conditioned grant from FIC (Fundación Investigación Cardiovascular).

Author information

Authors and Affiliations

  1. Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain

    Ravi Vazirani, Oscar Vedia Cruz & Iván J. Núñez-Gil

  2. Pediatric Cardiology Division of Puerta del Mar University Hospital, Cadiz, Spain

    Moisés Rodríguez-González & Ana Castellano-Martinez

  3. Department of Cardiology, Hospital Universitari Vall d´Hebron. VHIR - Vall d´Hebron Institut de Recerca. CIBERCV, Barcelona, Spain

    Mireia Andrés & Aitor Uribarri

  4. Department of Cardiology, Hospital Universitario de Albacete, Albacete, Spain

    Miguel Corbí-Pascual

  5. Department of Cardiology, Hospital Universitario de La Princesa, IIS-IP, CIBERCV, Universidad Autónoma de Madrid, Madrid, Spain

    Fernando Alfonso

  6. Department of Cardiology, Hospital Universitario Arnau de Vilanova, IRB LLeida, Lleida, Spain

    Emilia Blanco-Ponce

  7. Department of Cardiology, Hospital Universitario Juan Ramón Jimenez, Huelva, Spain

    Carmen Lluch-Requerey

  8. Department of Cardiology, Hospital Universitario Gregorio Marañón, Madrid, Spain

    Clara Fernández-Cordón

  9. Department of Cardiology, Hospital Universitario Virgen de la Macarena, Seville, Spain

    Manuel Almendro-Delia

  10. Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain

    Iván J. Núñez-Gil

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  1. Ravi Vazirani
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  2. Moisés Rodríguez-González
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  3. Ana Castellano-Martinez
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  13. Iván J. Núñez-Gil
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on behalf of RETAKO Investigators

Contributions

RV and IN created the idea and the original manuscript, MR, AC, and OV contributed with cases, and MA, AU, MC, FA, EB, CL, CF, and MA reviewed the manuscript and revised the literature.

Corresponding author

Correspondence to Iván J. Núñez-Gil.

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Ethical approval

The study complied with the Declaration of Helsinki and was approved by the Institutional Ethics Committee of the RETAKO coordinator center [19]. All patients provided informed consent.

Competing interests

The authors declare no competing interests.

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Vazirani, R., Rodríguez-González, M., Castellano-Martinez, A. et al. Pediatric takotsubo cardiomyopathy: A review and insights from a National Multicentric Registry. Heart Fail Rev (2024). https://doi.org/10.1007/s10741-024-10394-x

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