Happy Heart Syndrome: Frequency, Characteristics, and Outcome of Takotsubo Syndrome Triggered by Positive Life Events.


Journal

JACC. Heart failure
ISSN: 2213-1787
Titre abrégé: JACC Heart Fail
Pays: United States
ID NLM: 101598241

Informations de publication

Date de publication:
07 2022
Historique:
received: 08 11 2021
revised: 02 02 2022
accepted: 03 02 2022
entrez: 30 6 2022
pubmed: 1 7 2022
medline: 6 7 2022
Statut: ppublish

Résumé

The association with a preceding stressor is a characteristic feature of takotsubo syndrome (TTS). Negative emotions before TTS are common and led to the popular term "broken heart syndrome." In contrast, pleasant triggers ("happy heart syndrome") are rare and are scarcely investigated. The authors analyzed the frequency, clinical characteristics, and prognostic implications of positive emotional stressors in the multicenter GEIST (GErman-Italian-Spanish Takotsubo) Registry. Patients enrolled in the registry were categorized according to their stressors. This analysis compared patients with pleasant emotional events with patients with negative emotional events. Of 2,482 patients in the registry, 910 patients (36.7%) exhibited an emotional trigger consisting of 873 "broken hearts" (95.9%) and 37 "happy hearts" (4.1%). Consequently, the prevalence of pleasant emotional triggers was 1.5% of all TTS cases. Compared with patients with TTS with negative preceding events, patients with happy heart syndrome were more frequently male (18.9% vs 5.0%; P < 0.01) and had a higher prevalence of atypical ballooning patterns (27.0% vs 12.5%; P = 0.01), particularly midventricular ballooning. In-hospital complications, including death, pulmonary edema, cardiogenic shock, or stroke (8.1% vs 12.3%; P = 0.45), and long-term mortality rates (2.7% vs 8.8%; P = 0.20) were similar in "happy hearts" and "broken hearts." Happy heart syndrome is a rare type of TTS characterized by a higher prevalence of male patients and atypical, nonapical ballooning compared with patients with negative emotional stressors. Despite similar short- and long-term outcomes in our study, additional data are needed to explore whether numerically lower event rates in "happy hearts" would be statistically significant in a larger sample size. (GErman-Italian-Spanish Takotsubo Registry [GEIST Registry]; NCT04361994).

Sections du résumé

BACKGROUND
The association with a preceding stressor is a characteristic feature of takotsubo syndrome (TTS). Negative emotions before TTS are common and led to the popular term "broken heart syndrome." In contrast, pleasant triggers ("happy heart syndrome") are rare and are scarcely investigated.
OBJECTIVES
The authors analyzed the frequency, clinical characteristics, and prognostic implications of positive emotional stressors in the multicenter GEIST (GErman-Italian-Spanish Takotsubo) Registry.
METHODS
Patients enrolled in the registry were categorized according to their stressors. This analysis compared patients with pleasant emotional events with patients with negative emotional events.
RESULTS
Of 2,482 patients in the registry, 910 patients (36.7%) exhibited an emotional trigger consisting of 873 "broken hearts" (95.9%) and 37 "happy hearts" (4.1%). Consequently, the prevalence of pleasant emotional triggers was 1.5% of all TTS cases. Compared with patients with TTS with negative preceding events, patients with happy heart syndrome were more frequently male (18.9% vs 5.0%; P < 0.01) and had a higher prevalence of atypical ballooning patterns (27.0% vs 12.5%; P = 0.01), particularly midventricular ballooning. In-hospital complications, including death, pulmonary edema, cardiogenic shock, or stroke (8.1% vs 12.3%; P = 0.45), and long-term mortality rates (2.7% vs 8.8%; P = 0.20) were similar in "happy hearts" and "broken hearts."
CONCLUSIONS
Happy heart syndrome is a rare type of TTS characterized by a higher prevalence of male patients and atypical, nonapical ballooning compared with patients with negative emotional stressors. Despite similar short- and long-term outcomes in our study, additional data are needed to explore whether numerically lower event rates in "happy hearts" would be statistically significant in a larger sample size. (GErman-Italian-Spanish Takotsubo Registry [GEIST Registry]; NCT04361994).

Identifiants

pubmed: 35772855
pii: S2213-1779(22)00236-0
doi: 10.1016/j.jchf.2022.02.015
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT04361994']

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

459-466

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Auteurs

Thomas Stiermaier (T)

Medical Clinic II, University Heart Center Lübeck, Lübeck, Germany; German Center for Cardiovascular Research, Partner Site Hamburg-Kiel-Lübeck, Lübeck, Germany. Electronic address: thomas.stiermaier@uksh.de.

Alexandra Walliser (A)

Medical Clinic II, University Heart Center Lübeck, Lübeck, Germany.

Ibrahim El-Battrawy (I)

First Department of Medicine, University Medical Center Mannheim, Mannheim, Germany; German Center for Cardiovascular Research, Partner Site Heidelberg-Mannheim, Mannheim, Germany.

Toni Pätz (T)

Medical Clinic II, University Heart Center Lübeck, Lübeck, Germany.

Matthias Mezger (M)

Medical Clinic II, University Heart Center Lübeck, Lübeck, Germany.

Elias Rawish (E)

Medical Clinic II, University Heart Center Lübeck, Lübeck, Germany; German Center for Cardiovascular Research, Partner Site Hamburg-Kiel-Lübeck, Lübeck, Germany.

Mireia Andrés (M)

Cardiology Service, Vall d'Hebron University Hospital, Barcelona, Spain.

Manuel Almendro-Delia (M)

Cardiology Service, Virgen Macarena Hospital, Seville, Spain.

Manuel Martinez-Sellés (M)

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

Aitor Uribarri (A)

Cardiology Service, Valladolid University Hospital, Valladolid, Spain.

Alberto Pérez-Castellanos (A)

Cardiology Service, Son Espases University Hospital, Palma, Spain.

Federico Guerra (F)

Cardiology and Arrhythmology Clinic, Marche Polytechnic University, Umberto I-Lancisi-Salesi University Hospital, Ancona, Italy.

Giuseppina Novo (G)

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Cardiology Unit, University of Palermo, P. Giaccone University Hospital, Palermo, Italy.

Enrica Mariano (E)

Division of Cardiology, University of Rome Tor Vergata, Rome, Italy.

Maria Beatrice Musumeci (MB)

Department of Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.

Luca Arcari (L)

Institute of Cardiology, Madre Giuseppina Vannini Hospital, Rome, Italy.

Luca Cacciotti (L)

Institute of Cardiology, Madre Giuseppina Vannini Hospital, Rome, Italy.

Roberta Montisci (R)

Division of Clinical Cardiology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.

Ibrahim Akin (I)

First Department of Medicine, University Medical Center Mannheim, Mannheim, Germany; German Center for Cardiovascular Research, Partner Site Heidelberg-Mannheim, Mannheim, Germany.

Holger Thiele (H)

Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany.

Natale Daniele Brunetti (ND)

Department of Medical and Surgery Sciences, University of Foggia, Foggia, Italy.

Ivan J Núñez-Gil (IJ)

Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Hospital Clínico San Carlos, Complutense University of Madrid, Madrid, Spain.

Francesco Santoro (F)

Department of Medical and Surgery Sciences, University of Foggia, Foggia, Italy.

Ingo Eitel (I)

Medical Clinic II, University Heart Center Lübeck, Lübeck, Germany; German Center for Cardiovascular Research, Partner Site Hamburg-Kiel-Lübeck, Lübeck, Germany.

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