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. Copyright (c) 2010 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
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. Copyright (c) 2010 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
Authors: Alejandro Lemor; Alvaro J Ramos-Rodriguez; Ricardo De La Villa; Seyed H Hosseini Dehkordi; Fernando Vazquez de Lara; Shawn Lee; Mario Rodriguez Rivera; Abel Casso Dominguez; Edgar Argulian Journal: Clin Cardiol Date: 2018-11-26 Impact factor: 2.882
Authors: Ravi Korabathina; Jamie Porcadas; Kevin E Kip; Puja R Korabathina; Andrew D Rosenthal; Peter Wassmer Journal: Tex Heart Inst J Date: 2021-11-01