Clinical characteristics and prognostic factors of stress-induced cardiomyopathy.

Abstract:

BACKGROUND AND OBJECTIVES:Stress-induced cardiomyopathy (SCM) is characterized by a transient left ventricular (LV) dysfunction due to emotional and physical stress. There are limited data about the clinical characteristics in Korean patients. We sought to clarify the clinical features and prognosis in patients with SCM. SUBJECTS AND METHODS:We reviewed 39 cases diagnosed with SCM in a tertiary hospital. The SCM was diagnosed as: 1) no previous history of cardiac disease, 2) acute onset, 3) regional wall motion abnormality, typically in the takotsubo or inverted takotsubo shape by echocardiography, and 4) no significant stenosis in the coronary angiogram. We evaluated clinical characteristics, biomarkers, and prognosis. RESULTS:Mean age was 61.3+/-16.1 years (female 69%). The triggering factors were physical stress in 32 patients (82%) and emotional stress in 5 patients (13%). The initial symptom was dyspnea (n=18, 46%) rather than chest pain (n=10, 26%). An initial electrocardiogram (EKG) presented T-wave inversion (n=18, 46%), ST-elevation (n=11, 28%), and ST-depression (n=2, 5%). Multivariate logistic regression analysis showed that initial high sensitive C-reactive protein (hs-CRP) {odds ratio (OR) 1.41, 95% confidence interval (CI); 1.02-1.97} and initial left ventricular ejection fraction (LVEF) (OR 0.89, 95% CI; 0.80-0.98) were significantly associated with death or cardiogenic shock, respectively. CONCLUSION:The major triggering factor of SCM is physical stress due to illness or surgical procedures, and the first manifestation is dyspnea rather than chest pain. Elevated hs-CRP and decreased LVEF at admission were independent risk factors for death or cardiogenic shock.

journal_name

Korean Circ J

authors

Lee JW,Kim JY,Youn YJ,Sung JK,Lee NS,Lee KH,Yoo BS,Lee SH,Yoon J,Choe KH

doi

10.4070/kcj.2010.40.6.277

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

277-82

issue

6

eissn

1738-5520

issn

1738-5555

journal_volume

40

pub_type

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