{
  "abstract": "Introduction Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) may cause stress-induced transient acute cardiac dysfunction through myocardial stunning, in the form of exacerbation-triggered Takotsubo syndrome (referred to as Takotsubo stunning). Although prior studies suggest an association between AECOPD and transient cardiac dysfunction, existing evidence is limited to retrospective cohorts, case reports and expert consensus. Therefore, the incidence and clinical impact of Takotsubo stunning with acute heart failure (AHF) during AECOPD remain unknown and may be overlooked due to overlapping clinical symptoms. Cardiac Assessment and Takotsubo-stunning among COPD-exacerbations in-Hospital (CATCH study) aims to determine the incidence of Takotsubo stunning during AECOPD and to evaluate its clinical implication.Methods and analysis CATCH is a prospective observational cohort study enrolling adults (≥18 years) admitted for AECOPD at Sahlgrenska University Hospital (Gothenburg, Sweden). Participants with chronic left ventricular systolic dysfunction (left ventricular ejection fraction <50%), pre-existing chronic regional wall motion abnormalities (RWMA) or prior type 1 myocardial infarction are excluded. Following informed consent, participants undergo echocardiographic screening for RWMA and/or systolic left ventricular dysfunction. Screening-positive patients have follow-up echocardiography at 24 hours (±6) and 30 days (±48 hours). Those with reversible dysfunction constitute the CATCH case group, while screening-negative participants serve as controls. Additional assessments include ECG, chest X-ray, N-terminal pro-B-type natriuretic peptide blood analysis and COPD severity. Primary outcomes include the incidence of reversible RWMA or left ventricular dysfunction (proxy for Takotsubo stunning) and in-hospital clinical signs of AHF (Killip class >1). A sample size of 150 patients is required for detecting AHF differences (α=0.05, 80% power).Ethics and dissemination The study received ethical approval from the Swedish Ethical Review Authority. All participants provided written informed consent. Results will be disseminated through peer-reviewed journals and scientific meetings.Registration details The CATCH study is registered at ClinicalTrials.gov ( NCT06597331). The reference number for ethical approval is 2024-02071-01 (with addenda 2024-05448-02 and 2025-05861-02).",
  "authors": [
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden",
        "Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Rickard Zeijlon"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden"
      ],
      "name": "Sara Zooq"
    },
    {
      "affiliations": [
        "Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden",
        "Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden"
      ],
      "name": "Angela Poller"
    },
    {
      "affiliations": [
        "Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden",
        "Department of Respiratory Medicine, University Hospital Ghent, Ghent, Belgium"
      ],
      "name": "Lowie Vanfleteren"
    },
    {
      "affiliations": [
        "Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden",
        "Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden"
      ],
      "name": "Linnea Molander"
    },
    {
      "affiliations": [
        "Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Axel Andersson"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden",
        "Department of Research, Østfold Hospital Kalnes, Grålum, Norway"
      ],
      "name": "Mazdak Tavoly"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden"
      ],
      "name": "Peter Hällgren Nordhage"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden"
      ],
      "name": "Emma Westerlind"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden",
        "Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "N David Åberg"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden",
        "Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Johan Lönnbro"
    },
    {
      "affiliations": [
        "Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden",
        "Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden"
      ],
      "name": "Micael Oliveira Diniz"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden"
      ],
      "name": "Kanya Said"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden"
      ],
      "name": "Per Thysell"
    },
    {
      "affiliations": [
        "Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden",
        "Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden"
      ],
      "name": "Sandeep Jha"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden",
        "Department of Clinical Sciences, Lund University, Lund, Sweden"
      ],
      "name": "Tore Hedbäck"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden"
      ],
      "name": "Roxana Mincheva"
    },
    {
      "affiliations": [
        "Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden",
        "Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Johan-Emil Bager"
    }
  ],
  "title": "Cardiac Assessment and Takotsubo-stunning among COPD-exacerbations in-Hospital (CATCH study): when the lungs break your heart—protocol for a prospective observational cohort study",
  "uid": "6e4dda7d-1b48-5a61-a24d-29ab8ba081dd"
}