Gherardo Finocchiaro1, Yukari Kobayashi2, Emma Magavern2, Jessica Q Zhou2, Euan Ashley3, Gianfranco Sinagra4, Ingela Schnittger2, Joshua W Knowles5, William F Fearon2, Francois Haddad5, Jennifer A Tremmel2. 1. Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Palo Alto, California; Department of Cardiovascular Sciences, St. George's University of London, London, England. Electronic address: gherardobis@yahoo.it. 2. Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Palo Alto, California. 3. Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Palo Alto, California; Stanford Cardiovascular Institute, Palo Alto, California. Electronic address: euan@stanford.edu. 4. Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy. 5. Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Palo Alto, California; Stanford Cardiovascular Institute, Palo Alto, California.
Abstract
BACKGROUND: Stress-induced cardiomyopathy (SCM) is a reversible cardiomyopathy observed in patients without significant coronary disease. The aim of this study was to assess the incidence and clinical significance of right ventricular (RV) involvement in SCM. METHODS AND RESULTS: We retrospectively analyzed echocardiograms from 40 consecutive patients who presented with SCM at Stanford University Medical Center from September 2000 to November 2010. The primary end point was overall mortality. RV involvement was observed in 20 patients (50%; global RV hypokinesia in 15 patients and focal RV apical akinesia in 5 patients). The independent correlates of RV involvement were older age (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.02-1.7two, P = .01) and LVEF (per 10% decrease: OR 3.60, CI 1.77-7.32; P = .02). At a mean follow-up of 44 ± 32 months, 12 patients (30%) died (in-hospital death in 3 patients). At multivariate analysis, the presence of an RV fractional area change <35% emerged as an independent predictor of death (OR 3.6, CI 1.06-12.41; P = .04). CONCLUSIONS: RV involvement is a common finding in SCM, and may present as either global or focal RV apical involvement. Both older age and lower LVEF are associated with a higher risk of RV involvement, which appears to be a major predictor of death.
BACKGROUND: Stress-induced cardiomyopathy (SCM) is a reversible cardiomyopathy observed in patients without significant coronary disease. The aim of this study was to assess the incidence and clinical significance of right ventricular (RV) involvement in SCM. METHODS AND RESULTS: We retrospectively analyzed echocardiograms from 40 consecutive patients who presented with SCM at Stanford University Medical Center from September 2000 to November 2010. The primary end point was overall mortality. RV involvement was observed in 20 patients (50%; global RV hypokinesia in 15 patients and focal RV apical akinesia in 5 patients). The independent correlates of RV involvement were older age (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.02-1.7two, P = .01) and LVEF (per 10% decrease: OR 3.60, CI 1.77-7.32; P = .02). At a mean follow-up of 44 ± 32 months, 12 patients (30%) died (in-hospital death in 3 patients). At multivariate analysis, the presence of an RV fractional area change <35% emerged as an independent predictor of death (OR 3.6, CI 1.06-12.41; P = .04). CONCLUSIONS: RV involvement is a common finding in SCM, and may present as either global or focal RV apical involvement. Both older age and lower LVEF are associated with a higher risk of RV involvement, which appears to be a major predictor of death.
Authors: June Min Sung; Sung Jin Hong; In Hyun Chung; Hye Young Lee; Jae Hoon Lee; Hyun Jung Kim; Young Sup Byun; Byung Ok Kim; Kun Joo Rhee Journal: Yonsei Med J Date: 2017-01 Impact factor: 2.759
Authors: Jakob Park; Yekaterina Kim; Jason Pereira; Kerrilynn C Hennessey; Kamil F Faridi; Robert L McNamara; Eric J Velazquez; David J Hur; Lissa Sugeng; Vratika Agarwal Journal: Am Heart J Plus Date: 2021-06-01