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Clinical characteristics and prognostic factors of stress-induced cardiomyopathy.
MedLine Citation:
PMID:  20589200     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jun-Won Lee; Jang-Young Kim; Young-Jin Youn; Joong-Kyung Sung; Nam-Seok Lee; Kyoung-Hoon Lee; Byung-Su Yoo; Seung-Hwan Lee; Junghan Yoon; Kyung-Hoon Choe
Publication Detail:
Type:  Journal Article     Date:  2010-06-29
Journal Detail:
Title:  Korean circulation journal     Volume:  40     ISSN:  1738-5555     ISO Abbreviation:  Korean Circ J     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-30     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101247141     Medline TA:  Korean Circ J     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  277-82     Citation Subset:  -    
Affiliation:
Division of Cardiology, Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
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