Abstract

Takotsubo syndrome (TTS) in the pediatric population is an infrequent but relevant cause of morbidity and mortality, with limited studies addressing its clinical course and prognosis. We aimed to analyze the clinical features and prognosis of pediatric TTS in a nation-wide multicenter registry and considering the published literature. We included a total of 54 patients from 4 different hospitals in Spain, as well as pediatric TTS patients from the published literature. Comparisons between groups were performed in order to assess for statistically and clinically relevant prognostic differences between pediatric and adult population features. Patients with pediatric TTS are more commonly male and exhibit a higher prevalence of physical triggers. The left ventricular ejection fraction (LVEF) was significantly lower in the pediatric population (30.5 + 10.4 vs 36.9 + 16.9, p < 0.05), resulting in more than fivefold rates of cardiogenic shock on admission compared to the general adult TTS population (Killip IV 74.1% vs 10.5%, p < 0.001) with similar rates of death and recurrence between groups. TTS in the pediatric population presents a distinctive clinical profile, with higher prevalence of atypical symptoms and physical triggers, as well as higher rates of cardiogenic shock on admission and similar mortality and recurrence rates than those of the adult population. This study provides valuable insights into understanding pediatric TTS and underscores the necessity for further research in this age group.

Graphical Abstract

中文翻译：

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小儿章鱼壶心肌病：国家多中心登记处的回顾和见解

摘要

Takotsubo 综合征 (TTS) 在儿科人群中是一种罕见但与发病率和死亡率相关的原因，针对其临床病程和预后的研究有限。我们的目的是在全国多中心登记处分析儿科 TTS 的临床特征和预后，并考虑已发表的文献。我们总共纳入了来自西班牙 4 家不同医院的 54 名患者，以及已发表文献中的儿科 TTS 患者。进行组间比较，以评估儿童和成人群体特征之间的统计和临床相关预后差异。儿童 TTS 患者多为男性，并且身体触发因素的发生率较高。儿科人群的左心室射血分数 (LVEF) 显着较低（30.5 + 10.4 vs 36.9 + 16.9，p  < 0.05），导致入院时心源性休克的发生率是一般成人 TTS 人群的五倍多 (Killip IV 74.1% vs 10.5%，p  < 0.001），组间死亡率和复发率相似。儿科人群中的 TTS 呈现出独特的临床特征，与成人人群相比，非典型症状和身体触发因素的患病率更高，入院时心源性休克的发生率更高，死亡率和复发率相似。这项研究为理解儿科 TTS 提供了宝贵的见解，并强调了对该年龄段进行进一步研究的必要性。

图形概要