{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:44:42Z","timestamp":1790862282080,"version":"4.1.0"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,2,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Neurological disorders as a risk factor for Takotsubo syndrome (TTS) are not well characterized. The aim of the study was to evaluate TTS\u2010associated neurological phenotypes and outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with TTS enrolled in the international multicenter GEIST (German Italian Spanish Takotsubo) registry were analyzed. Prevalence, clinical characteristics, and short\u2010 and long\u2010term outcomes of patients with TTS were recorded. A subgroup analysis of the 5 most represented neurological disorders was performed.<\/jats:p>\n                    <jats:p xml:lang=\"en\">\n                      In total, 400 (17%) of 2301 patients had neurological disorders. The most represented neurological conditions were previous cerebrovascular events (39%), followed by neurodegenerative disorders (30.7%), migraine (10%), epilepsy (9.5%), and brain tumors (5%). During hospitalization, patients with neurological disorders had longer in\u2010hospital stay (8 [interquartile range, 5\u201312] versus 6 [interquartile range, 5\u20139] days;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01) and more often experienced in\u2010hospital complications (27% versus 16%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.01) mainly driven by cardiogenic shock and in\u2010hospital death (12% versus 7.6% and 6.5% versus 2.8%, respectively; both\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01). Survival analysis showed a higher mortality rate in neurological patients both at 60\u2009days and long\u2010term (8.8% versus 3.4% and 23.5% versus 10.1%, respectively; both\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01). Neurological disorder was an independent predictor of both the 60\u2010day and long\u2010term mortality rate (odds ratio, 1.78 [95% CI, 1.07\u20132.97];\n                      <jats:italic>P<\/jats:italic>\n                      =0.02; hazard ratio, 1.72 [95% CI, 1.33\u20132.22]; both\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Patients with neurodegenerative disorders had the worst prognosis among the neurological disease subgroups, whereas patients with TTS with migraine had a favorable prognosis (long\u2010term mortality rates, 29.2% and 9.7%, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Neurological disorders identify a high\u2010risk TTS subgroup for enhanced short\u2010 and long\u2010term mortality rate. Careful recognition of neurological disorders and phenotype is therefore needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.032128","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T06:29:12Z","timestamp":1707892152000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Neurological Disorders in Takotsubo Syndrome: Clinical Phenotypes and Outcomes"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9909-6513","authenticated-orcid":false,"given":"Francesco","family":"Santoro","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences University of Foggia Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1779-3102","authenticated-orcid":false,"given":"Iv\u00e1n J.","family":"N\u00fa\u00f1ez 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Neurology\u2010Stroke Unit University Hospital Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0139-1045","authenticated-orcid":false,"given":"Ibrahim","family":"El\u2010Battrawy","sequence":"additional","affiliation":[{"name":"Department of Cardiology University of Mannheim Mannheim Germany"},{"name":"DZHK (German Center for Cardiovascular Research), Partner Site Mannheim Mannheim Germany"},{"name":"Department of Cardiology and Angiology Bergmannsheil University Hospitals, Ruhr University of Bochum Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Guerra","sequence":"additional","affiliation":[{"name":"Cardiology and Arrhythmology Clinic Marche Polytechnic University, University Hospital \u201cUmberto I \u2013 Lancisi \u2013 Salesi\u201d Ancona 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