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

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• 作者：Sung Woo Kwon ; Byung Ok Kim ; Myung-Hyun Kim ; Sung-Joo Lee ; Ji Hyun Yoon ; Hyemoon Chung ; Chi-Young Shim ; Duk Kyu Cho ; Sung Kee Ryu ; Se-Jung Yoon ; Young Won Yoon ; Hyuk-Jae Chang ; Se-Joong Rim ; Hyuck Moon Kwon ; Yangsoo Jang ; Bum-Kee Hong
• 关键词：Takotsubo cardiomyopathy ; Echocardiography ; Hospital mortality ; Prognosis
• 刊名：International Journal of Cardiology
• 出版年：2013
• 出版时间：20 September, 2013
• 年：2013
• 卷：168
• 期：1
• 页码：331-337
• 全文大小：482 K

文摘

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.