Validation of Takotsubo Syndrome Scoring System

<b>Background</b>: Takotsubo syndrome (TS) mimics acute coronary syndrome in 1% to 3% of patients presenting with chest pain, ECG changes and echocardiographic transient apical wall hypokinesia. <b>Objectives</b>: This study aimed to validate a previously developed scoring sy...

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Main Authors: Dana Deeb, Ranel Loutati, Louay Taha, Mohammad Karmi, Akiva Brin, Ofir Rabi, Nir Levi, Noam Fink, Pierre Sabouret, Mohammed Manassra, Abed Qadan, Motaz Amro, Benyamin Khalev, Michael Glikson, Elad Asher
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Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/11/1314
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author Dana Deeb
Ranel Loutati
Louay Taha
Mohammad Karmi
Akiva Brin
Ofir Rabi
Nir Levi
Noam Fink
Pierre Sabouret
Mohammed Manassra
Abed Qadan
Motaz Amro
Benyamin Khalev
Michael Glikson
Elad Asher
author_facet Dana Deeb
Ranel Loutati
Louay Taha
Mohammad Karmi
Akiva Brin
Ofir Rabi
Nir Levi
Noam Fink
Pierre Sabouret
Mohammed Manassra
Abed Qadan
Motaz Amro
Benyamin Khalev
Michael Glikson
Elad Asher
author_sort Dana Deeb
collection DOAJ
description <b>Background</b>: Takotsubo syndrome (TS) mimics acute coronary syndrome in 1% to 3% of patients presenting with chest pain, ECG changes and echocardiographic transient apical wall hypokinesia. <b>Objectives</b>: This study aimed to validate a previously developed scoring system on a larger cohort size. <b>Methods</b>: Patients admitted to an intensive cardiovascular care unit were divided into three groups: (a) patients diagnosed with TS, (b) females with anterior MI, and (c) other all-comer STEMIs. A 10-point scoring system was used: stressful events (three points), female gender (two points), no history of diabetes mellitus (two points), estimated left ventricular ejection fraction (LVEF) ≤ 40% on admission echocardiography (one point), positive troponin on admission (one point), and no smoking (one point). A <i>t</i>-test was applied to the three study groups, sensitivity and specificity testing was performed using the ROC curve method. <b>Results</b>: A total of 1150 patients were included in our study: 54 with TS, 97 females with anterior MI and 999 other all-comer STEMIs. Patients in the TS group were predominantly females with a higher rate of stressful events prior to admission, lower rates of diabetes mellitus and smoking, and lower LVEF% systolic function compared to the STEMI cohort. In a multivariate logistic regression analysis, the average TS scoring system was significantly higher in the TS group compared with the anterior STEMI and all-comer STEMI groups (8.3 vs. 5.7 vs. 3.83, <i>p</i> < 0.001, respectively) with an AUC of 0.83 for TS score ≥ 8. <b>Conclusions</b>: The 10-point TS scoring system is an easy, reliable, and useful diagnostic tool that might help in distinguishing patients with TS and ACS.
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spelling doaj-art-36af99a40d8f4d35b9203eaf97e737fa2025-08-20T02:32:57ZengMDPI AGDiagnostics2075-44182025-05-011511131410.3390/diagnostics15111314Validation of Takotsubo Syndrome Scoring SystemDana Deeb0Ranel Loutati1Louay Taha2Mohammad Karmi3Akiva Brin4Ofir Rabi5Nir Levi6Noam Fink7Pierre Sabouret8Mohammed Manassra9Abed Qadan10Motaz Amro11Benyamin Khalev12Michael Glikson13Elad Asher14Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelAssuta Medical Centers, Tel Aviv 6329302, IsraelCollege of French Cardiologists, 13 Rue Niepce, 75014 Paris, FranceJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Eisenberg R&D Authority and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9103102, Israel<b>Background</b>: Takotsubo syndrome (TS) mimics acute coronary syndrome in 1% to 3% of patients presenting with chest pain, ECG changes and echocardiographic transient apical wall hypokinesia. <b>Objectives</b>: This study aimed to validate a previously developed scoring system on a larger cohort size. <b>Methods</b>: Patients admitted to an intensive cardiovascular care unit were divided into three groups: (a) patients diagnosed with TS, (b) females with anterior MI, and (c) other all-comer STEMIs. A 10-point scoring system was used: stressful events (three points), female gender (two points), no history of diabetes mellitus (two points), estimated left ventricular ejection fraction (LVEF) ≤ 40% on admission echocardiography (one point), positive troponin on admission (one point), and no smoking (one point). A <i>t</i>-test was applied to the three study groups, sensitivity and specificity testing was performed using the ROC curve method. <b>Results</b>: A total of 1150 patients were included in our study: 54 with TS, 97 females with anterior MI and 999 other all-comer STEMIs. Patients in the TS group were predominantly females with a higher rate of stressful events prior to admission, lower rates of diabetes mellitus and smoking, and lower LVEF% systolic function compared to the STEMI cohort. In a multivariate logistic regression analysis, the average TS scoring system was significantly higher in the TS group compared with the anterior STEMI and all-comer STEMI groups (8.3 vs. 5.7 vs. 3.83, <i>p</i> < 0.001, respectively) with an AUC of 0.83 for TS score ≥ 8. <b>Conclusions</b>: The 10-point TS scoring system is an easy, reliable, and useful diagnostic tool that might help in distinguishing patients with TS and ACS.https://www.mdpi.com/2075-4418/15/11/1314Takotsubo syndromeBroken-heart syndromeapical ballooningscoring system
spellingShingle Dana Deeb
Ranel Loutati
Louay Taha
Mohammad Karmi
Akiva Brin
Ofir Rabi
Nir Levi
Noam Fink
Pierre Sabouret
Mohammed Manassra
Abed Qadan
Motaz Amro
Benyamin Khalev
Michael Glikson
Elad Asher
Validation of Takotsubo Syndrome Scoring System
Diagnostics
Takotsubo syndrome
Broken-heart syndrome
apical ballooning
scoring system
title Validation of Takotsubo Syndrome Scoring System
title_full Validation of Takotsubo Syndrome Scoring System
title_fullStr Validation of Takotsubo Syndrome Scoring System
title_full_unstemmed Validation of Takotsubo Syndrome Scoring System
title_short Validation of Takotsubo Syndrome Scoring System
title_sort validation of takotsubo syndrome scoring system
topic Takotsubo syndrome
Broken-heart syndrome
apical ballooning
scoring system
url https://www.mdpi.com/2075-4418/15/11/1314
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