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Int J Cardiol. 2013 Sep 20;168(1):331-7. doi: 10.1016/j.ijcard.2012.09.050. Epub 2012 Oct 4.

Diverse left ventricular morphology and predictors of short-term outcome in patients with stress-induced cardiomyopathy.

Author information

1
Division of Cardiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.

Abstract

BACKGROUND:

There is paucity of data with regard to the clinical spectrum according to left ventricle (LV) morphological variation in stress-induced cardiomyopathy (SCMP) patients, and still there is controversy in terms of prognosis since some people believe that the published in-hospital mortality data of patients with SCMP are underestimated. Therefore, we sought to investigate the morphological features of LV and in-hospital outcome of patients with SCMP and explored predictors of short-term prognosis.

METHODS:

This was a multicenter, observational study of 208 SCMP patients. Morphological features of LV were determined by echocardiography and were divided into typical (apical) and atypical ballooning types, which were subcategorized into mid-LV ballooning and basal 'inverted' ballooning type. All-cause mortality of patients with SCMP during hospitalization was recorded.

RESULTS:

The apical ballooning type was most common (67.3%) in SCMP followed by the mid-LV ballooning type (28.3%), and the basal 'inverted' ballooning type (4.3%). There were no differences in stressor types and in-hospital mortality between patients with typical and atypical SCMP. Notably, all the in-hospital mortality of SCMP patients occurred in patients with physical stressors, where age, shock, and LV ejection fraction were the independent risk factors for predicting in-hospital mortality.

CONCLUSIONS:

SCMP patients showed diverse patterns of LV morphology, but there were no definite differences on clinical spectrum among SCMP patients presenting various LV morphological patterns. In terms of short-term prognosis, underlying physical conditions combined with old age, hemodynamic compromise, and low LV systolic function might be the most important factors in SCMP patients.

KEYWORDS:

Echocardiography; Hospital mortality; Prognosis; Takotsubo cardiomyopathy

PMID:
23041089
DOI:
10.1016/j.ijcard.2012.09.050
[Indexed for MEDLINE]

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