Mechanical circulatory support for Takotsubo syndrome: a systematic review and meta-analysis
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu časopisecké články, metaanalýza, systematický přehled
PubMed
32473281
DOI
10.1016/j.ijcard.2020.05.033
PII: S0167-5273(20)31840-4
Knihovny.cz E-zdroje
- Klíčová slova
- Cardiac arrest, Cardiogenic shock, ECLS, ECMO, Extracorporeal membrane oxygenation, Heart failure, Impella, Mechanical circulatory support, Takotsubo syndrome,
- MeSH
- funkce levé komory srdeční MeSH
- kardiogenní šok diagnóza terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- podpůrné srdeční systémy * MeSH
- prospektivní studie MeSH
- takotsubo kardiomyopatie * diagnóza epidemiologie terapie MeSH
- tepový objem MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- systematický přehled MeSH
BACKGROUND: Cardiogenic shock occurs in 10%-15% of patients with Takotsubo syndrome (TS). For several reasons catecholamines, and especially inotropes, should be avoided in TS. Temporary mechanical circulatory support (MCS) appears attractive as bridge-to-recovery, but prospective studies are lacking. Here we analyze the available literature on MCS use in patients with TS. METHODS AND RESULTS: PubMed/Medline was systematically screened until December 2019. 18 studies reporting pooled data of 5629 TS patients, of whom 227 had received MCS, were considered for a qualitative synthesis. 81 articles from 2003 through 2019 reporting individual data of 93 MCS cases were included in a meta-analysis. Median age was 57 (IQR: 43-68) years, 83.9% were women, and a physical trigger could be identified in 74.1% of cases. Median left ventricular ejection fraction (LVEF) before MCS was 20% (IQR: 15-25) and comparable between groups defined by MCS device. An apical TS type was present in 76.1% of cases. The overall number of publications on MCS for TS increased over time, as did those using veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and Impella, while those using intra-aortic balloon pump declined. MCS-related complications were not regularly reported. Median time on MCS was 3 (IQR: 2-7) days, with an overall survival of 94.6%. CONCLUSIONS: MCS for TS-related shock is increasingly reported, with a growing use of V-A ECMO and Impella. Currently available clinical data support this approach. Prospective studies are needed to evaluate safety and efficacy of different devices as well as timing of MCS in this special patient population.
Citace poskytuje Crossref.org
