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KMID : 0882420110810010064
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Korean Journal of Medicine
2011 Volume.81 No. 1 p.64 ~ p.72
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Predictors of In-Hospital Mortality and Left Ventricular Functional Recovery in Korean Patients with Stress-Induced Cardiomyopathy: Stress-Induced Cardiomyopathy Registry Data
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Jo Hyun-su
Hong Gue-Ru
Sohn Chang-Woo
Sohn Jang-Won
Yoon Joon-Chul
Lee Sang-Hee
Park Jong-Seon
Shin Dong-Gu
Kim Young-Jo
Kim Hyung-Seop
Kim Kee-Sik
Kim So-Yeon
Park Yong-Hyun
Cho Kyoung-Im
Kim Jang-Young
Hong Kyung-Soon
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Abstract
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Background/Aims: The reported frequency of stress-induced cardiomyopathy (SCMP, Takotsubo cardiomyopathy) is increasing; however, there are no data regarding predictors of in-hospital mortality and the recovery of left ventricular (LV) systolic function in patients with SCMP. Therefore, in this study, we sought to identify clinical predictors of in-hospital mortality and of the recovery of LV dysfunction in Korean patients with SCMP.
Methods: From November 2004 to November 2010, 155 patients who fulfilled the clinical diagnostic criteria of the Mayo clinic for SCMP were enrolled retrospectively from eight medical centers in Korea. We checked in-hospital deaths and compared the LV ejection fraction (LVEF) and wall-motion score index (WMSI) upon enrollment for each patient with that after 1 week using echocardiograms. A total of 55 continuous variables and 52 nominal variables were analyzed to find variables associated with in-hospital mortality and the recovery of LV dysfunction. All significant variables were entered into a logistic regression analysis.
Results: The mean age of the patients was 64 ± 15 years; 118 (76.1%) patients were female. The in-hospital mortality rate was 5.2% (n = 8). An elevated initial platelet count was identified as a predictor of in-hospital mortality (odds ratio [95% CI]: 0.99 [0.99-1.00]). There were no predictors of the recovery of LVEF. Predictors of the recovery of WMSI were an absence of arrhythmic events (odds ratio [95% CI]: 22.89 [1.98-265.34]) and an elevated initial LV end-systolic diameter (odds ratio [95% CI]: 0.86 [0.74-1.00]).
Conclusions : An initial absence of arrhythmic events and elevated LV end-diastolic pressure in patients with SCMP may be predictors of the timely recovery of LV dysfunction.
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KEYWORD
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Takotsubo cardiomyopathy, In-hospital mortality, Left ventricular dysfunction
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