Outcomes of Patients with Stress-Induced Cardiomyopathy Diagnosed by Echocardiography in a Tertiary Referral Hospital
- Authors
- Lee P.H.; Song J.-K.; Sun B.J.; Choi H.O.; Seo J.-S.; Na J.O.; Kim D.-H.; Song J.-M.; Kang D.-H.; Kim J.-J.; Park S.-W.
- Issue Date
- Jul-2010
- Keywords
- Echocardiography; Outcome; Stress; Takotsubo cardiomyopathy
- Citation
- Journal of the American Society of Echocardiography, v.23, no.7, pp 766 - 771
- Pages
- 6
- Indexed
- SCOPUS
- Journal Title
- Journal of the American Society of Echocardiography
- Volume
- 23
- Number
- 7
- Start Page
- 766
- End Page
- 771
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/15509
- DOI
- 10.1016/j.echo.2010.05.002
- ISSN
- 0894-7317
1097-6795
- Abstract
- Background: Because stress-induced cardiomyopathy (SIC) is increasingly being observed during routine daily practice, we sought to explore the clinical features and factors that determine the outcome of SIC in a tertiary referral hospital. Methods: Patients with typical left ventricular (LV) takotsubo (apical ballooning) or inverted takotsubo on 2-dimensional echocardiography were prospectively enrolled, and their clinical data were analyzed. Results: Over a 63-month period, 56 consecutive patients (median age and interquartile range = 64 years [52-74 years]) were identified. Women comprised 79% (44/56) of all patients. The triggering events were acute medical illness, including sepsis and hypoxemia in 29 patients (52%, group A), in-hospital surgery/procedure in 17 patients (30%, group B), and emotional stress in 10 patients (18%, group C). Chest pain was more frequently observed in group C (50%) than in groups A (14%) and B (6%) (P = .021), whereas dyspnea was the presenting symptom in groups A and B. Typical takotsubo and inverted takotsubo were observed in 48 and 8 patients, with a median ejection fraction of 33%. Other abnormalities included dynamic LV outflow tract obstruction (n = 2), LV thrombus (n = 2), and right ventricular dysfunction (n = 12). Nine deaths (16%) occurred during hospitalization. The groups did not differ in mortality. The Acute Physiology and Chronic Health Evaluation II score (odds ratio 1.405; 95% confidence interval, 1.091-1.810; P = .009) and absence of LV function recovery within 1 week (ejection fraction < 50%) (odds ratio 14.080; 95% confidence interval, 1.184-167.475; P = .036) were independent factors associated with mortality. During clinical follow-up up to 6 months, 3 more patients died, 2 of whom had recurrences of SIC. Conclusions: SIC in a tertiary referral hospital was mainly associated with physical stressors and characterized by diverse clinical presentations, high mortality, and occasional fatal recurrences. © 2010 American Society of Echocardiography.
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Collections - 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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