Exploring sex-specific clinical features in Chinese patients with Takotsubo syndrome

Abstract Background Takotsubo syndrome (TTS) is considered as a transient acute heart failure syndrome predominant in females. However, data on Chinese TTS patients are limited. Therefore, this study aimed to investigate the clinical characteristics of Chinese TTS patients, identify prognostic marke...

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Main Authors: Hong-Yi Duan, Ling-Lin Wang, Ling-Chun Lyu, Zhen-Hua Shi, Xiao-Ping Lin, Zheng-Yang Yu, Guo-Hua Fan, Jing Chen, Xin-Hong Yang, Wei Deng, Chang-Wu Xu, Yan Huang, Qing Zhou, Jin-Ling Chen, Hong-Ning Song, Dong Hu, Jin-Qiu Liu, Hector Barajas-Martinez, Charles Antzelevitch, Kan Liu, Hong Jiang, Dan Hu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-04788-4
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author Hong-Yi Duan
Ling-Lin Wang
Ling-Chun Lyu
Zhen-Hua Shi
Xiao-Ping Lin
Zheng-Yang Yu
Guo-Hua Fan
Jing Chen
Xin-Hong Yang
Wei Deng
Chang-Wu Xu
Yan Huang
Qing Zhou
Jin-Ling Chen
Hong-Ning Song
Dong Hu
Jin-Qiu Liu
Hector Barajas-Martinez
Charles Antzelevitch
Kan Liu
Hong Jiang
Dan Hu
author_facet Hong-Yi Duan
Ling-Lin Wang
Ling-Chun Lyu
Zhen-Hua Shi
Xiao-Ping Lin
Zheng-Yang Yu
Guo-Hua Fan
Jing Chen
Xin-Hong Yang
Wei Deng
Chang-Wu Xu
Yan Huang
Qing Zhou
Jin-Ling Chen
Hong-Ning Song
Dong Hu
Jin-Qiu Liu
Hector Barajas-Martinez
Charles Antzelevitch
Kan Liu
Hong Jiang
Dan Hu
author_sort Hong-Yi Duan
collection DOAJ
description Abstract Background Takotsubo syndrome (TTS) is considered as a transient acute heart failure syndrome predominant in females. However, data on Chinese TTS patients are limited. Therefore, this study aimed to investigate the clinical characteristics of Chinese TTS patients, identify prognostic markers. Methods A total of 258 TTS patients were enrolled. Data on clinical characteristics and in-hospital major adverse cardiovascular events (MACE) were collected and analyzed. The latter included severe heart failure, shock, malignant arrhythmia, and death. Results The average age of TTS patients was 59.3 ± 19.2 years. Female patients accounted for 68.9%. MACE occurred in 41.4% of patients during hospitalization. Compared with males, female TTS patients were older, had more emotional causes, higher proportion of typical apical ballooning type, higher LVEF, more prolonged QTc, as well as lower early repolarization (ER) and MACE ratio (35.6% vs. 53.8%, P = 0.006). Compared to female patients with emotional triggers, those female patients with physical triggers are younger, have a lower proportion of chest pain and abnormal ECG, but are more prone to experiencing MACE. Physical triggers, CKMB, LVEF, non-apical ballooning, ER pattern and premature ventricular beats were independent predictors of in-hospital MACE, whereas age, physical triggers and platelet count were specifically independent predictors for female TTS cases. Conclusions Chinese TTS patients demonstrate unique clinical characteristics and in-hospital outcomes. Apart from the well-known fact that male with TTS has high-risk phenotype, our study newly identifies that TTS females with younger age or physical triggers also have worse prognosis, which warrants close attention and follow-up.
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spelling doaj-art-bb001cd5986c4e3d975aaa19d670edc42025-08-20T03:37:23ZengBMCBMC Cardiovascular Disorders1471-22612025-07-0125111410.1186/s12872-025-04788-4Exploring sex-specific clinical features in Chinese patients with Takotsubo syndromeHong-Yi Duan0Ling-Lin Wang1Ling-Chun Lyu2Zhen-Hua Shi3Xiao-Ping Lin4Zheng-Yang Yu5Guo-Hua Fan6Jing Chen7Xin-Hong Yang8Wei Deng9Chang-Wu Xu10Yan Huang11Qing Zhou12Jin-Ling Chen13Hong-Ning Song14Dong Hu15Jin-Qiu Liu16Hector Barajas-Martinez17Charles Antzelevitch18Kan Liu19Hong Jiang20Dan Hu21Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan UniversityDepartment of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan UniversityLishui Central Hospital and the Fifth Affiliated Hospital of Wenzhou Medical UniversityLishui Central Hospital and the Fifth Affiliated Hospital of Wenzhou Medical UniversityDepartment of Cardiology, Second Affiliated Hospital, Zhejiang University School of MedicineDepartment of Cardiology, Second Affiliated Hospital, Zhejiang University School of MedicineDepartment of Thoracic Surgery, Renmin Hospital of Wuhan UniversityDepartment of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan UniversityDepartment of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan UniversityDepartment of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan UniversityDepartment of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan UniversityDepartment of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan UniversityDepartment of Ultrasonography, Renmin Hospital of Wuhan UniversityDepartment of Ultrasonography, Renmin Hospital of Wuhan UniversityDepartment of Ultrasonography, Renmin Hospital of Wuhan UniversityCenter for Stem Cell Research and Application, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Cardiology, The First Affiliated Hospital of Dalian Medical UniversityLankenau Institute for Medical Research, and Lankenau Heart InstituteLankenau Institute for Medical Research, and Lankenau Heart InstituteDivision of Cardiology, Washington University in St. LouisDepartment of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan UniversityDepartment of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan UniversityAbstract Background Takotsubo syndrome (TTS) is considered as a transient acute heart failure syndrome predominant in females. However, data on Chinese TTS patients are limited. Therefore, this study aimed to investigate the clinical characteristics of Chinese TTS patients, identify prognostic markers. Methods A total of 258 TTS patients were enrolled. Data on clinical characteristics and in-hospital major adverse cardiovascular events (MACE) were collected and analyzed. The latter included severe heart failure, shock, malignant arrhythmia, and death. Results The average age of TTS patients was 59.3 ± 19.2 years. Female patients accounted for 68.9%. MACE occurred in 41.4% of patients during hospitalization. Compared with males, female TTS patients were older, had more emotional causes, higher proportion of typical apical ballooning type, higher LVEF, more prolonged QTc, as well as lower early repolarization (ER) and MACE ratio (35.6% vs. 53.8%, P = 0.006). Compared to female patients with emotional triggers, those female patients with physical triggers are younger, have a lower proportion of chest pain and abnormal ECG, but are more prone to experiencing MACE. Physical triggers, CKMB, LVEF, non-apical ballooning, ER pattern and premature ventricular beats were independent predictors of in-hospital MACE, whereas age, physical triggers and platelet count were specifically independent predictors for female TTS cases. Conclusions Chinese TTS patients demonstrate unique clinical characteristics and in-hospital outcomes. Apart from the well-known fact that male with TTS has high-risk phenotype, our study newly identifies that TTS females with younger age or physical triggers also have worse prognosis, which warrants close attention and follow-up.https://doi.org/10.1186/s12872-025-04788-4Takotsubo syndromeWomenHeart failureArrhythmiaTriggersPrognosis
spellingShingle Hong-Yi Duan
Ling-Lin Wang
Ling-Chun Lyu
Zhen-Hua Shi
Xiao-Ping Lin
Zheng-Yang Yu
Guo-Hua Fan
Jing Chen
Xin-Hong Yang
Wei Deng
Chang-Wu Xu
Yan Huang
Qing Zhou
Jin-Ling Chen
Hong-Ning Song
Dong Hu
Jin-Qiu Liu
Hector Barajas-Martinez
Charles Antzelevitch
Kan Liu
Hong Jiang
Dan Hu
Exploring sex-specific clinical features in Chinese patients with Takotsubo syndrome
BMC Cardiovascular Disorders
Takotsubo syndrome
Women
Heart failure
Arrhythmia
Triggers
Prognosis
title Exploring sex-specific clinical features in Chinese patients with Takotsubo syndrome
title_full Exploring sex-specific clinical features in Chinese patients with Takotsubo syndrome
title_fullStr Exploring sex-specific clinical features in Chinese patients with Takotsubo syndrome
title_full_unstemmed Exploring sex-specific clinical features in Chinese patients with Takotsubo syndrome
title_short Exploring sex-specific clinical features in Chinese patients with Takotsubo syndrome
title_sort exploring sex specific clinical features in chinese patients with takotsubo syndrome
topic Takotsubo syndrome
Women
Heart failure
Arrhythmia
Triggers
Prognosis
url https://doi.org/10.1186/s12872-025-04788-4
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