Korean J Med.  2011 Jul;81(1):64-72.

Predictors of In-Hospital Mortality and Left Ventricular Functional Recovery in Korean Patients with Stress-Induced Cardiomyopathy: Stress-Induced Cardiomyopathy Registry Data

Affiliations
  • 1Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea. grhong@med.yu.ac.kr
  • 2Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
  • 3Department of Internal Medicine, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
  • 4Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea.
  • 5Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
  • 6Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea.
  • 7Department of Internal Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 8Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.

Abstract

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.

Keyword

Takotsubo cardiomyopathy; In-hospital mortality; Left ventricular dysfunction

MeSH Terms

Cardiomyopathies
Female
Hospital Mortality
Humans
Korea
Logistic Models
Platelet Count
Retrospective Studies
Takotsubo Cardiomyopathy
Ventricular Dysfunction, Left
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