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Prognostic Outcome of Stress-induced Cardiomyopathy According to Morphologic Features of Left Ventricle: Comparison between Typical vs. Atypical Type
연세대학교 강남세브란스병원¹ , 연세대학교 용인세브란스병원² , 인제대학교 상계백병원³ , 연세대학교 신촌세브란스병원⁴ , 관동대학교 명지병원5 , 을지대학교 서울을지병원6 , 국민건강보험공단 일산병원7
정혜문¹ , 권성우² , 윤지현¹ , 문희선¹ , 김병옥³ , 심지영⁴ , 조덕규5 , 유승기6 , 윤세정7 , 김종윤¹ , 최의영¹ , 이지혁² , 민필기¹ , 윤영원¹ , 이병권¹ , 임세중¹ , 권혁문¹ , 홍범기¹
Background: Stress-induced cardiomyopathy (SCMP) is a unique transient cardiomyopathy that mimics acute myocardial infarction. Besides various triggers and many possible pathophysiologic considerations, SCMP also demonstrates diverse morphologic features of left ventricle (LV). However, there is lack of data with regard to the prognostic outcome according to morphologic features of LV. Objectives: Therefore, we investigated if prognosis of SCMP differs according to morphologic features of LV - that is to compare the prognostic outcome between typical vs. atypical type. Methods: This was a multi-center, retrospective study. We enrolled 234 patients from 1998 to 2010 admitted to 6 tertiary referral hospitals with confirmed diagnosis of SCMP by angiography. Morphologic features of LV were categorized into typical and atypical type. Typical type was considered as apical ballooning type with basal segment hyperkinesis, whereas atypical type as a composite of mid-LV ballooning, apical tip sparing, reverse, or unclassified type. Recurrence of SCMP and all-cause mortality were recorded and regarded as an endpoint. Results: Overall, 139 patients were typical type, and the rest 95 patients were atypical type. During the mean follow-up of 712 ± 724 days (0 - 4323 days), 2 patients (None in typical type and 2 in atypical type) had recurrence of SCMP and 29 patients (18 in typical type and 11 in atypical type) died. However, survival analysis using Kaplan-Meier method revealed that there was no prognostic difference between typical vs. atypical type of SCMP (88.5% vs. 86.3%, p=0.339)(Figure 1). Conclusions: The prognostic outcome of SCMP showed no difference between typical vs. atypical type. Therefore, morphologic features of left ventricle was not a prognostic determinant in SCMP patients.
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