Different Characteristics between Patients with Apical and Non-Apical Subtypes of Stress-Induced Cardiomyopathy.
10.4250/jcu.2013.21.3.116
- Author:
Sun Hwa LEE
1
;
Won Ho KIM
;
Sang Rok LEE
;
Kyung Suk RHEE
;
Jei Keon CHAE
;
Jae Ki KO
Author Information
1. Division of Cardiology, Department of Internal Medicine, Chonbuk National University Medical School & Hospital, Jeonju, Korea. shleemd@jbnu.ac.kr
- Publication Type:Original Article
- Keywords:
Stress cardiomyopathy;
Echocardiography
- MeSH:
Chest Pain;
Echocardiography;
Electrocardiography;
Hospital Mortality;
Humans;
Pulmonary Edema;
Shock, Cardiogenic;
Takotsubo Cardiomyopathy*
- From:Journal of Cardiovascular Ultrasound
2013;21(3):116-122
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Stress-induced cardiomyopathy (SCM) is characterized by apical ballooning on echocardiography, but some of SCM patients show non-apical involvement and their characteristics are not well defined. METHODS: We investigated 56 patients that were diagnosed as SCM and divided them into 2 groups: apical ballooning syndrome (ABS, n = 49, 87.5%) and non-apical ballooning syndrome (N-ABS, n = 7, 12.5%) groups. Patients with N-ABS were significantly younger than those of the ABS group (52 +/- 11 vs. 73 +/- 10 years, p < 0.001). RESULTS: Types of preceding stressors and clinical presentation including chest pain, pulmonary edema, cardiogenic shock and in-hospital mortality were comparable between the two groups. In the N-ABS group, wall motion score index was significantly lower than in the ABS group (1.61 +/- 0.35 vs. 1.93 +/- 0.31, p = 0.016). On electrocardiogram (ECG), T-wave inversion (57.1% vs. 95.8%, p < 0.001) were less frequent in the N-ABS than in the ABS group. Furthermore, maximum QT and corrected QT (QTc) intervals in the N-ABS patients were significantly shorter than the ABS patients (QT, 419.9 +/- 66.1 vs. 487.3 +/- 79.6 ms, p = 0.038; QTc, 479.0 +/- 61.9 vs. 568.0 +/- 50.5 ms, p < 0.001). CONCLUSION: Patients with the N-ABS showed not only atypical echocardiographic findings, but also atypical clinical and ECG manifestations. Integrated consideration is needed to reach a diagnosis of the non-apical subtype of SCM.
