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Renal dysfunction in Takotsubo syndrome—role of segmental left ventricle strain analysis
Author(s) -
Dias Andre,
Franco Emiliana,
Agrawal Akanksha,
Hebert Kathy,
Ladron de Guevara Felix,
Rangaswami Janina,
Figueredo Vincent M.
Publication year - 2019
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14184
Subject(s) - medicine , creatinine , acute kidney injury , acute coronary syndrome , cardiology , rifle , speckle tracking echocardiography , ventricle , renal function , troponin , troponin t , heart failure , myocardial infarction , ejection fraction , archaeology , history
Background Takotsubo syndrome ( TTS ) is a peculiar clinical condition often resembling an acute coronary syndrome and mostly affecting postmenopausal women. We sought to describe the prevalence of acute kidney injury and acute renal failure in TTS patients during index event and assess the usefulness of speckle tracking echocardiography in predicting subjects at risk of developing acute kidney insult. Methods We conducted a retrospective descriptive study reviewing study with the discharge diagnosis of TTS between 2003‐2016 at our Institution. One hundred and two patients met the Modified Mayo Clinic. Acute kidney injury ( AKI ) was defined as an increment of serum creatinine 2 times greater than baseline and/or at least 50% reduction in baseline eGFR . Acute renal failure ( ARF ) was defined as an increment of serum creatinine 3 times greater than baseline and/or at least 75% reduction in baseline eGFR as per RIFLE Classification. Results AKI / ARF patients had longer length of stay (24 vs 10 days, P = 0.02), had higher mean peak troponin (16.7 ng/mL vs 3.2, P < 0.05) and later peak creatinine day (10 vs 3, P < 0.05). LV Longitudinal strain in the basal segment and apex upon admission was significantly worse in the AKI / ARF group (−4.7 and −6.5, respectively, vs −8.6 and −9.1 in the non‐ AKI / ARF group, P < 0.05). Conclusions One in every 10 TTS patients may develop AKI / ARF during the acute episode. Segmental longitudinal strain by speckle tracking may have important prognostic value in identifying TTS patients at risk of developing AKI / ARF .