BACKGROUND The pathophysiology of takotsubo syndrome (TTS) and its recurrence (REC-TTS) is still elusive. Various ventriculographic "ballooning" patterns in response to a variety of triggers are observed in patients with REC-TTS. Although patients with and without REC-TTS have been previously compared, no comparison of patients' 1st TTS episode (1stTTS) with the 1st REC-TTS episode (1stREC-TTS) has been attempted. METHODS All patients with ≥1 REC-TTS episodes with patient-based data (45 variables) from the world literature, retrieved via PubMed, were meta-analyzed, and the patients' 1st REC-TTS and stREC-TTS were compared. RESULTS The time interval between the 1stTTS and 1stREC-TTS of the meta-analyzed 128 patients, 117 (91.4%) female, was 30.4 ± 36.1 months, with 47 (36.7%) patients having a neurological and/or psychiatric comorbidity(ies). Among 113 patients with paired 1stTTS and 1stREC-TTS data on the ventriculographic "ballooning" appearance, 101 (78.9%) had a different variant during the 1stTTS as compared with the 1stREC-TTS. Six patients (4.7%) died during hospitalization. Thirty patients (23.4%) were taking a β-blocker prior to their 1strTTS. Among 19 variables compared between the 1st TTS and 1st REC-TTS episodes, only mean age (by 2.5 years) and use of β-blockers were statistically significantly different. The precipitating triggers, and the in-hospital adverse events were similar in the 1st TTS and 1st REC-TTS episodes. CONCLUSIONS A comparison of the 1st TTS and 1st REC-TTS episodes of patients with REC-TTS, revealed large variation in the ventriculographic "ballooning" patterns, similarity in the TTS triggers, and no difference in the in-hospital adverse events. There was no protective effect for imparted by β-blockers in REC-TTS.

中文翻译：

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世界文献128例takotsubo综合征首发与首发复发的比较：病理生理学意义。

背景技术takotsubo综合征（TTS）及其复发（REC-TTS）的病理生理学仍然难以捉摸。在REC-TTS患者中观察到对各种触发因素有反应的各种心室“气球”模式。尽管先前已对有和没有REC-TTS的患者进行了比较，但尚未尝试将患者的第1 TTS发作（1stTTS）与第1 REC-TTS发作（1stREC-TTS）进行比较。方法对通过PubMed检索的来自世界文献的≥1REC-TTS发作并以患者为基础的数据（45个变量）进行荟萃分析，并比较患者的第1 REC-TTS和stREC-TTS。结果经荟萃分析的128例患者中1stTTS和1stREC-TTS之间的时间间隔为117（91.4％）位女性，为30.4±36.1个月，其中47个月（36。7％）患有神经和/或精神疾病合并症的患者。在113例具有脑室“气球状”表现的1stTTS和1stREC-TTS数据配对的患者中，与1stREC-TTS相比，有101例（78.9％）在1stTTS期间有不同的变异。6名患者（4.7％）在住院期间死亡。30名患者（23.4％）在接受1strTTS之前服用了β受体阻滞剂。在第1次TTS和第1次REC-TTS发作之间比较的19个变量中，只有平均年龄（2.5岁）和使用β受体阻滞剂在统计学上有显着差异。在第1次TTS和第1次REC-TTS发作中，诱发因素和院内不良事件相似。结论对REC-TTS患者的第1次TTS和第1次REC-TTS发作进行比较后发现，脑室“气球”模式有很大差异，TTS触发因素相似，院内不良事件无差异。REC-TTS中β受体阻滞剂没有保护作用。