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Heart failure & cardiomyopathiesCohort study

Independent prognostic value of left ventricular stroke volume index in patients with takotsubo syndrome: insights from the EVOLUTION registry

HeartPublished

  • observational study
  • registry
  • centralised cardiac magnetic resonance (CMR) analysis
  • consecutive patients
Read the original article ↗

Authors' conclusion

Early CMR after admission in patients with TTS highlights recovering LVEF with relatively low LVSVi. Low LVSVi independently predicted mid-term outcomes, and the presence of both high LVSVi and recovered LVEF identified a low-risk subgroup.

Study context

Population
Consecutive patients with takotsubo syndrome (TTS) who underwent CMR at median 5 days (3–7) after admissionmean age 70±11 years, 9% male
Participants
376 patients
Exposure
Left ventricular stroke volume indexed (LVSVi) <35 vs ≥35 mL/m²
  • LVSVi <35 mL/m²n = 172
Outcome
Composite of:
  • Major adverse cardiovascular events
  • All-cause-death
Follow-up
Median 360 days

Main finding

As reported in the abstract

Hazard ratio

0.96

95% CI 0.92–0.98

LVSVi <35 vs ≥35 mL/m²
HR 0.96 (95% CI 0.92–0.98)
Higher primary endpoint rate in the low-LVSVi group (Kaplan-Meier)
log-rank p<0.01
Lowest event rates in patients having both high LVSVi and normal left ventricular ejection fraction (LVEF)
log-rank p<0.01

Observational data: associations, not effects.

Secondary outcomes

All-cause-death (secondary endpoint) · Median follow-up 360 days

ComparisonHR (95% CI)
LVSVi · Multivariable Cox-regression; LVSVi as independent predictor0.95 (0.90–0.99)
All-cause-death (secondary endpoint) — Higher secondary endpoint rate in the low-LVSVi group (Kaplan-Meier)
log-rank p<0.01

LVEF · On admission and at CMR imaging

Average LVEF on admission
43%
LVEF at CMR imaging
48%

Characteristics of low LVSVi patients

Older, higher prevalence of hypertension and dyspnoea and a lower LVEF at admission
On CMR: smaller LV end-diastolic volumes, lower biventricular systolic function and larger myocardial oedema

Original publication

Independent prognostic value of left ventricular stroke volume index in patients with takotsubo syndrome: insights from the EVOLUTION registry. Heart. Published 8 June 2026. doi:10.1136/heartjnl-2026-327797
Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it