Key result
Stress-induced cardiomyopathy demonstrates LVEF recovery and regional wall motion normalization in ~30 days.
Why the study?
Stress-induced cardiomyopathy mimicking acute myocardial infarction has been recently reported, but clinical characteristics in a Korean series were not previously studied.
Observational (n=18)
No
This prospective registry describes the clinical features of stress-induced cardiomyopathy in a Korean cohort, highlighting its presentation mimicking acute myocardial infarction and subsequent rapid recovery of left ventricular function.
Rapid LVEF recovery may guide follow-up in stress cardiomyopathy; extends small Asian cohorts but leaves open generalizability.
Background and Objectives:The so-called 'stress-induced cardiomyopathy' or takotsubo cardiomyopathy, mimicking acute myocardial infarction (AMI, has recently been reported, particularly in Japan. We pro- spectively studied the clinical characteristics of, for the first time with a Korean series, this novel syndrome. Subjects and Methods:Eighteen patients, fore filling the inclusion criteria, were entered onto the study. The criteria for inclusion were:1 no previous history of cardiac disease, 2 acute onset, 3 a regional wall motion abnormality in the left ventriculogram, typically in the apical segment, and 4 no significant stenosis in the coronary angiogram. Results:The events preceding the condition included:emotional stress (N=7, acute illness (N=5, non-cardiac surgery or medical procedure (N=4 and accident (N=2. Chest pain, dyspnea, or nausea/vomiting were initially noted in 12 cases (66%. Pulmonary edema was demonstrated in 10 (56%, and cardiogenic shock in 4 (23% of the patients. The peak creatinine kinase MB fraction was 69±136 IU/L. A T wave inversion was noted in all patients, whereas, a Q wave was noted transiently in only 1. The average left ventricular ejection fraction (LVEF was 38±8% on the initial echocardiograms. On the left ventriculograms, 15 patients showed akinetic wall motion, or aneurysmal dilatation in the apical wall, however, notably in 3 patients in the mid-ventricular wall. The coronary vasospasm provocation tests were negative in all 10 patients tested. An intravascular ultrasonography showed no infarct-related plaques in the 4 patients examined. On a follow-up echocardiogram, the average LVEF was improved to 51±8%, and regional wall motion was normalized after 30±29 days following onset. Conclusion:We report, for the first time in a series of Korean patients, on a novel stress-induced cardiomyopathy with transient regional wall motion abnormality, mimicking AMI. The precise etiology remains to be elucidated in further studies. (Korean Circulation J 2002;32(12 :1054-1063
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Lee et al. (2002) conducted an observational in Stress-induced cardiomyopathy (n=18). Stress-induced cardiomyopathy was evaluated on Clinical characteristics and left ventricular function recovery. In 18 Korean patients with stress-induced cardiomyopathy, average left ventricular ejection fraction improved from 38±8% to 51±8% and regional wall motion normalized after 30±29 days.
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