Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://cr.elmerpub.com

Original Article

Volume 17, Number 5, October 2026, pages 466-475

Takotsubo Syndrome: Clinical and Diagnostic Characteristics of 26 Consecutively Hospitalized Patients Over a Five-Year Period

Figures

↓ Figure 1. Demographic characteristics of the cohort. (a) Sex distribution: 88.5% women (n = 23) and 11.5% men (n = 3). (b) Age distribution: predominance of patients aged > 65 years (73.1%, n = 19).

↓ Figure 2. Triggering event. (a) Proportion of emotional vs. physical/somatic triggers. (b) Subcategory breakdown of trigger types.

↓ Figure 3. Initial LVEF. (a) Histogram color-coded by dysfunction severity: severely reduced < 35% (n = 9), moderately reduced 35–49% (n = 10), preserved ≥ 50% (n = 7). (b) LVEF by age group (boxplots). LVEF: left ventricular ejection fraction.

↓ Figure 4. Control echocardiography at discharge. (a) All 26 patients. (b) 24 survivors, 91.7% with persistently reduced LVEF. LVEF: left ventricular ejection fraction.

↓ Figure 5. Scatter plot depicting the correlation between initial LVEF and NT-proBNP (n = 17), with linear regression line and 95% confidence interval. Pearson r = −0.53. LVEF: left ventricular ejection fraction; NT-proBNP: N-terminal pro-B-type natriuretic peptide.

↓ Figure 6. Cardiac biomarkers on admission. Box-strip plots for hs-TnT (ng/mL), NT-proBNP (pg/mL), and CRP (mg/L) with individual patient values overlaid. CRP: C-reactive protein; hs-TnT: high-sensitivity troponin T; NT-proBNP: N-terminal pro-B-type natriuretic peptide.

↓ Figure 7. Pearson correlation coefficients (r) of clinical and biochemical parameters with initial LVEF. Red bars indicate a moderate inverse correlation (|r| > 0.30). LVEF: left ventricular ejection fraction.

↓ Figure 8. Pharmacological treatment. (a) Individual drug frequencies. (b) Number of concurrent drugs. (c) Specific regimens. (d) Two-drug combinations. (e) Three-drug combinations.

↓ Figure 9. Echocardiographic findings on admission: apical ballooning (100%), PAH (57.7%), valvular regurgitation (24%), LVOT obstruction (4.8%), LVEF normalization at discharge (8.3%). LVEF: left ventricular ejection fraction; LVOT: LV outflow tract; PAH: pulmonary arterial hypertension.

↓ Figure 10. LOS. (a) Distribution across the full cohort. (b) Mean LOS (± SD) stratified by age group and sex. LOS: length of hospital stay; SD: standard deviation.

Tables

↓ **Table 1.** Baseline Clinical and Hemodynamic Characteristics
Parameter	Value (mean ± SD) or n (%)
BP: blood pressure; bpm: beats per minute; SD: standard deviation.
Number of patients	26
Systolic BP (mm Hg)	126 ± 19
Diastolic BP (mm Hg)	74 ±12
Heart rate (bpm)	88 ± 15
Central venous congestion, n/N (%)	17/25 (68%)
Peripheral edema, n/N (%)	3/25 (12%)

↓ **Table 2.** Echocardiographic Parameters
Parameter	Mean ± SD	Median	IQR/range
IQR: interquartile range; LVEDV: LV end-diastolic volume; LVEF: LV ejection fraction; LVESV: LV end-systolic volume; LVOT: LV outflow tract; PAH: pulmonary arterial hypertension; SD: standard deviation.
Baseline LVEF (%)	41.8 ± 11.4	41	33–50/25–62
LVEDV (mL)	104 ± 45	85	72–130
LVESV (mL)	59.8 ± 32.4	48	36–71
Apical ballooning, n/N (%)	26/26 (100%)	-	-
PAH, n/N (%)	15/26 (57.7%)	-	-
Valvular regurgitation, n/N (%)	6/25 (24%)	-	-
LVOT obstruction, n/N (%)	1/21 (4.8%)	-	-
LVEF recovery at discharge, n/N (%)	2/24 (8.3%)	-	-

↓ **Table 3.** Biomarkers on Admission
Parameter	n	Mean ± SD	Median (IQR)
AST: aspartate aminotransferase; CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration; CPK: creatine phosphokinase; CRP: C-reactive protein; eGFR: estimated GFR; hs-TnT: high-sensitivity troponin T; IQR: interquartile range; NT-proBNP: N-terminal pro-B-type natriuretic peptide.
hs-TnT (ng/mL)	25	0.32 ± 0.40	0.16 (0.07–0.31)
NT-proBNP (pg/mL)	17	16,116 ± 14,260	11,273 (2,514–28,788)
CPK (U/L)	25	276.8 ± 426.3	135 (77–293)
CPK-MB (U/L)	25	42.6 ± 47.6	24 (17–46)
AST (U/L)	25	168.6 ± 449.5	42 (23–66)
CRP (mg/L)	24	34.6 ± 50.7	13.0 (3.3–39.4)
Creatinine (µmol/L)	25	98.5 ± 40.2	96 (74–116)
eGFR CKD-EPI (mL/min/1.73 m²)	25	61.6 ± 26.5	57 (42–73)
Hemoglobin (g/L)	25	128.5 ± 22.5	132 (117–140)

↓ **Table 4.** Hospitalization Duration and Outcomes
Parameter	Value
LOS: length of hospital stay; SD: standard deviation.
Mean LOS (days), mean ± SD	12.1 ± 10.2
Median LOS (days), IQR	7 (5–20)
LOS > 65 years (days), mean ± SD	13.9 ± 11.0
LOS 45–65 years (days), mean ± SD	6.8 ± 3.6
LOS females (days), mean ± SD	13.0 ± 10.6
LOS males (days), mean ± SD	5.3 ± 1.5
In-hospital complications, n/N (%)	5/20 (25.0%)
In-hospital mortality, n (%)	2/26 (7.7%)