The Role of Malnutrition, Nutritional Deficiencies and Eating Disorders in Patients with Takotsubo Syndrome-Scoping Review.

objectivesTakotsubo syndrome (TTS) is an acute, often reversible disorder of left ventricular systolic function, the pathophysiology of which is complex and still being studied. A growing body of clinical research indicates that patients' nutritional status may substantially influence the development and trajectory of Takotsubo syndrome. This review aims to systematically identify, map, and synthesize the existing scientific evidence on how malnutrition, nutrient deficiencies, and eating disorders contribute to Takotsubo syndrome (TTS), with particular attention being paid to the underlying pathophysiological mechanisms, predisposing factors, clinical manifestations, and prognostic implications.

methodsThe scoping review was carried out following the methodological framework of the Joanna Briggs Institute (JBI) and in alignment with the PRISMA-ScR reporting standards. A comprehensive search for descriptors and keywords was performed across six electronic databases: PubMed, Scopus, Web of Science, EBSCO (MEDLINE Complete), Cochrane Library, and Google Scholar on 23-30 April 2026. Systematic reviews and meta-analyses were screened only to map the existing evidence landscape and identify research gaps, but they were not used as primary sources of data nor included in the final evidence synthesis. In line with scoping review methodology, no formal appraisal of the methodological quality of the included studies was undertaken.

resultsOf the 19 articles initially identified, 8 met the inclusion criteria following a rigorous selection process. Key findings indicate that malnutrition on hospital admission is associated with significantly higher rates of 30-day adverse events and in-hospital mortality in patients with TTS. Eating disorders such as anorexia nervosa, by inducing electrolyte disorders and autonomic dysfunction, increase susceptibility to TTS and its complications. The impact of specific deficiencies (e.g., vitamin D) on the deterioration of hemodynamic parameters and the risk associated with renutrition syndrome that may trigger rare variants of TTS has also been documented.

conclusionsMalnutrition, nutritional deficiencies, and eating disorders are significant risk factors and prognosis modifiers in patients with Takotsubo syndrome, leading to an increased incidence of complications and mortality. Early and comprehensive management of nutritional status, including identification and correction of deficiencies and interdisciplinary treatment of eating disorders, is critical to improving clinical outcomes in this vulnerable patient population.