BACKGROUND Takotsubo cardiomyopathy(TCM),or stress-induced cardiomyopathy,is associated with adverse prognosis.Limited data suggest that TCM occurring in orthotopic liver transplant(OLT)recipients is associated with e...BACKGROUND Takotsubo cardiomyopathy(TCM),or stress-induced cardiomyopathy,is associated with adverse prognosis.Limited data suggest that TCM occurring in orthotopic liver transplant(OLT)recipients is associated with elevated perioperative risk.AIM To characterize the predictors of TCM in OLT recipients,using a large,multicenter pooled electronic health database.METHODS A multi-institutional database(Explorys Inc,Cleveland,OH,USA),an aggregate of de-identified electronic health record data from 26 United States healthcare systems was surveyed.A cohort of patients with a Systematized Nomenclature of Medicine-Clinical Terms of“liver transplant”between 09/2015 and 09/2020 was identified.Subsequently,individuals who developed a new diagnosis of TCM following OLT were identified.Furthermore,the risk associations with TCM among this patient population were characterized using linear regression.RESULTS Between 09/2015 and 09/2020,of 37718540 patients in the database,38740(0.10%)had a history of OLT(60.6%had an age between 18-65 years,58.1%female).A new diagnosis of TCM was identified in 0.3%of OLT recipients(45.5%had an age between 18-65 years,72.7%female),compared to 0.04%in non-OLT patients[odds ratio(OR):7.98,95%confidence intervals:6.62-9.63,(P<0.0001)].OLT recipients who developed TCM,compared to those who did not,were more likely to be greater than 65 years of age,Caucasian,and female(P<0.05).There was also a significant association with cardiac arrhythmias,especially ventricular arrhythmias(P<0.0001).CONCLUSION TCM was significantly more likely to occur in LT recipients vs non-recipients.Older age,Caucasian ethnicity,female gender,and presence of arrhythmias were significantly associated with TCM in LT recipients.展开更多
文摘BACKGROUND Takotsubo cardiomyopathy(TCM),or stress-induced cardiomyopathy,is associated with adverse prognosis.Limited data suggest that TCM occurring in orthotopic liver transplant(OLT)recipients is associated with elevated perioperative risk.AIM To characterize the predictors of TCM in OLT recipients,using a large,multicenter pooled electronic health database.METHODS A multi-institutional database(Explorys Inc,Cleveland,OH,USA),an aggregate of de-identified electronic health record data from 26 United States healthcare systems was surveyed.A cohort of patients with a Systematized Nomenclature of Medicine-Clinical Terms of“liver transplant”between 09/2015 and 09/2020 was identified.Subsequently,individuals who developed a new diagnosis of TCM following OLT were identified.Furthermore,the risk associations with TCM among this patient population were characterized using linear regression.RESULTS Between 09/2015 and 09/2020,of 37718540 patients in the database,38740(0.10%)had a history of OLT(60.6%had an age between 18-65 years,58.1%female).A new diagnosis of TCM was identified in 0.3%of OLT recipients(45.5%had an age between 18-65 years,72.7%female),compared to 0.04%in non-OLT patients[odds ratio(OR):7.98,95%confidence intervals:6.62-9.63,(P<0.0001)].OLT recipients who developed TCM,compared to those who did not,were more likely to be greater than 65 years of age,Caucasian,and female(P<0.05).There was also a significant association with cardiac arrhythmias,especially ventricular arrhythmias(P<0.0001).CONCLUSION TCM was significantly more likely to occur in LT recipients vs non-recipients.Older age,Caucasian ethnicity,female gender,and presence of arrhythmias were significantly associated with TCM in LT recipients.
