Prevalence and Prognostic Role of Right Ventricular Involvement in Stress-Induced Cardiomyopathy
Abstract Background Stress-induced cardiomyopathy (SCM) is a reversible cardiomyopathy observed in patients without significant coronary disease. The aim of this study was to assess the incidence and clinical significance of right ventricular (RV) involvement in SCM. Methods and Results We retrospec...
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| Veröffentlicht in: | Journal of cardiac failure 2015-05, Vol.21 (5), p.419-425 |
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| creator | Finocchiaro, Gherardo, MD Kobayashi, Yukari, MD Magavern, Emma, BA, MD Zhou, Jessica Q., MD Ashley, Euan, MD, DPhil Sinagra, Gianfranco, MD Schnittger, Ingela, MD Knowles, Joshua W., MD, PhD Fearon, William F., MD Haddad, Francois, MD Tremmel, Jennifer A., MD, MS |
| description | Abstract Background Stress-induced cardiomyopathy (SCM) is a reversible cardiomyopathy observed in patients without significant coronary disease. The aim of this study was to assess the incidence and clinical significance of right ventricular (RV) involvement in SCM. Methods and Results We retrospectively analyzed echocardiograms from 40 consecutive patients who presented with SCM at Stanford University Medical Center from September 2000 to November 2010. The primary end point was overall mortality. RV involvement was observed in 20 patients (50%; global RV hypokinesia in 15 patients and focal RV apical akinesia in 5 patients). The independent correlates of RV involvement were older age (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.02–1.7two, P = .01) and LVEF (per 10% decrease: OR 3.60, CI 1.77–7.32; P = .02). At a mean follow-up of 44 ± 32 months, 12 patients (30%) died (in-hospital death in 3 patients). At multivariate analysis, the presence of an RV fractional area change |
| doi_str_mv | 10.1016/j.cardfail.2015.02.001 |
| format | Article |
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The aim of this study was to assess the incidence and clinical significance of right ventricular (RV) involvement in SCM. Methods and Results We retrospectively analyzed echocardiograms from 40 consecutive patients who presented with SCM at Stanford University Medical Center from September 2000 to November 2010. The primary end point was overall mortality. RV involvement was observed in 20 patients (50%; global RV hypokinesia in 15 patients and focal RV apical akinesia in 5 patients). The independent correlates of RV involvement were older age (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.02–1.7two, P = .01) and LVEF (per 10% decrease: OR 3.60, CI 1.77–7.32; P = .02). At a mean follow-up of 44 ± 32 months, 12 patients (30%) died (in-hospital death in 3 patients). At multivariate analysis, the presence of an RV fractional area change <35% emerged as an independent predictor of death (OR 3.6, CI 1.06–12.41; P = .04). Conclusions RV involvement is a common finding in SCM, and may present as either global or focal RV apical involvement. Both older age and lower LVEF are associated with a higher risk of RV involvement, which appears to be a major predictor of death.</description><identifier>ISSN: 1071-9164</identifier><identifier>EISSN: 1532-8414</identifier><identifier>DOI: 10.1016/j.cardfail.2015.02.001</identifier><identifier>PMID: 25704104</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Cardiovascular ; Cohort Studies ; echocardiography ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Prognosis ; Retrospective Studies ; right ventricle ; Stress cardiomyopathy ; Stroke Volume - physiology ; Takotsubo Cardiomyopathy - diagnosis ; Takotsubo Cardiomyopathy - epidemiology ; Takotsubo Cardiomyopathy - physiopathology ; Ventricular Dysfunction, Right - diagnosis ; Ventricular Dysfunction, Right - epidemiology ; Ventricular Dysfunction, Right - physiopathology</subject><ispartof>Journal of cardiac failure, 2015-05, Vol.21 (5), p.419-425</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c493t-ddaa363ed6dd87b873b1bb9f018bceaa3bc05cdd05427f86e983d1f70c8327c43</citedby><cites>FETCH-LOGICAL-c493t-ddaa363ed6dd87b873b1bb9f018bceaa3bc05cdd05427f86e983d1f70c8327c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.cardfail.2015.02.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25704104$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Finocchiaro, Gherardo, MD</creatorcontrib><creatorcontrib>Kobayashi, Yukari, MD</creatorcontrib><creatorcontrib>Magavern, Emma, BA, MD</creatorcontrib><creatorcontrib>Zhou, Jessica Q., MD</creatorcontrib><creatorcontrib>Ashley, Euan, MD, DPhil</creatorcontrib><creatorcontrib>Sinagra, Gianfranco, MD</creatorcontrib><creatorcontrib>Schnittger, Ingela, MD</creatorcontrib><creatorcontrib>Knowles, Joshua W., MD, PhD</creatorcontrib><creatorcontrib>Fearon, William F., MD</creatorcontrib><creatorcontrib>Haddad, Francois, MD</creatorcontrib><creatorcontrib>Tremmel, Jennifer A., MD, MS</creatorcontrib><title>Prevalence and Prognostic Role of Right Ventricular Involvement in Stress-Induced Cardiomyopathy</title><title>Journal of cardiac failure</title><addtitle>J Card Fail</addtitle><description>Abstract Background Stress-induced cardiomyopathy (SCM) is a reversible cardiomyopathy observed in patients without significant coronary disease. The aim of this study was to assess the incidence and clinical significance of right ventricular (RV) involvement in SCM. Methods and Results We retrospectively analyzed echocardiograms from 40 consecutive patients who presented with SCM at Stanford University Medical Center from September 2000 to November 2010. The primary end point was overall mortality. RV involvement was observed in 20 patients (50%; global RV hypokinesia in 15 patients and focal RV apical akinesia in 5 patients). The independent correlates of RV involvement were older age (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.02–1.7two, P = .01) and LVEF (per 10% decrease: OR 3.60, CI 1.77–7.32; P = .02). At a mean follow-up of 44 ± 32 months, 12 patients (30%) died (in-hospital death in 3 patients). At multivariate analysis, the presence of an RV fractional area change <35% emerged as an independent predictor of death (OR 3.6, CI 1.06–12.41; P = .04). Conclusions RV involvement is a common finding in SCM, and may present as either global or focal RV apical involvement. Both older age and lower LVEF are associated with a higher risk of RV involvement, which appears to be a major predictor of death.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiovascular</subject><subject>Cohort Studies</subject><subject>echocardiography</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>right ventricle</subject><subject>Stress cardiomyopathy</subject><subject>Stroke Volume - physiology</subject><subject>Takotsubo Cardiomyopathy - diagnosis</subject><subject>Takotsubo Cardiomyopathy - epidemiology</subject><subject>Takotsubo Cardiomyopathy - physiopathology</subject><subject>Ventricular Dysfunction, Right - diagnosis</subject><subject>Ventricular Dysfunction, Right - epidemiology</subject><subject>Ventricular Dysfunction, Right - physiopathology</subject><issn>1071-9164</issn><issn>1532-8414</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUFv1DAQhSMEoqXwFyofuSSMYyf2XhBoVWClSlQtcDWOPWm9eO3FTlbaf4-jbTlw4eSR_d6M53tVdUmhoUD7d9vG6GRH7XzTAu0aaBsA-qw6px1ra8kpf15qELRe0Z6fVa9y3gKA5CBeVmdtJ4BT4OfVz5uEB-0xGCQ6WHKT4n2IeXKG3EaPJI7k1t0_TOQHhik5M3udyCYcoj_grlwRF8jdlDDnehPsbNCSdfmYi7tj3Ovp4fi6ejFqn_HN43lRff909W39pb7--nmz_nhdG75iU22t1qxnaHtrpRikYAMdhtUIVA4Gy9tgoDPWQsdbMcoeV5JZOgowkrXCcHZRvT313af4e8Y8qZ3LBr3XAeOcFe2FFFyC7Iu0P0lNijknHNU-uZ1OR0VBLXTVVj3RVQtdBa0qdIvx8nHGPOzQ_rU94SyCDycBlk0PDpPKxi1srUtoJmWj-_-M9_-0MN4FZ7T_hUfM2zinUDgqqnIxqLsl4yVi2pV4OWPsD56-pRk</recordid><startdate>20150501</startdate><enddate>20150501</enddate><creator>Finocchiaro, Gherardo, MD</creator><creator>Kobayashi, Yukari, MD</creator><creator>Magavern, Emma, BA, MD</creator><creator>Zhou, Jessica Q., MD</creator><creator>Ashley, Euan, MD, DPhil</creator><creator>Sinagra, Gianfranco, MD</creator><creator>Schnittger, Ingela, MD</creator><creator>Knowles, Joshua W., MD, PhD</creator><creator>Fearon, William F., MD</creator><creator>Haddad, Francois, MD</creator><creator>Tremmel, Jennifer A., MD, MS</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150501</creationdate><title>Prevalence and Prognostic Role of Right Ventricular Involvement in Stress-Induced Cardiomyopathy</title><author>Finocchiaro, Gherardo, MD ; Kobayashi, Yukari, MD ; Magavern, Emma, BA, MD ; Zhou, Jessica Q., MD ; Ashley, Euan, MD, DPhil ; Sinagra, Gianfranco, MD ; Schnittger, Ingela, MD ; Knowles, Joshua W., MD, PhD ; Fearon, William F., MD ; Haddad, Francois, MD ; Tremmel, Jennifer A., MD, MS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c493t-ddaa363ed6dd87b873b1bb9f018bceaa3bc05cdd05427f86e983d1f70c8327c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiovascular</topic><topic>Cohort Studies</topic><topic>echocardiography</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>right ventricle</topic><topic>Stress cardiomyopathy</topic><topic>Stroke Volume - physiology</topic><topic>Takotsubo Cardiomyopathy - diagnosis</topic><topic>Takotsubo Cardiomyopathy - epidemiology</topic><topic>Takotsubo Cardiomyopathy - physiopathology</topic><topic>Ventricular Dysfunction, Right - diagnosis</topic><topic>Ventricular Dysfunction, Right - epidemiology</topic><topic>Ventricular Dysfunction, Right - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Finocchiaro, Gherardo, MD</creatorcontrib><creatorcontrib>Kobayashi, Yukari, MD</creatorcontrib><creatorcontrib>Magavern, Emma, BA, MD</creatorcontrib><creatorcontrib>Zhou, Jessica Q., MD</creatorcontrib><creatorcontrib>Ashley, Euan, MD, DPhil</creatorcontrib><creatorcontrib>Sinagra, Gianfranco, MD</creatorcontrib><creatorcontrib>Schnittger, Ingela, MD</creatorcontrib><creatorcontrib>Knowles, Joshua W., MD, PhD</creatorcontrib><creatorcontrib>Fearon, William F., MD</creatorcontrib><creatorcontrib>Haddad, Francois, MD</creatorcontrib><creatorcontrib>Tremmel, Jennifer A., MD, MS</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiac failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Finocchiaro, Gherardo, MD</au><au>Kobayashi, Yukari, MD</au><au>Magavern, Emma, BA, MD</au><au>Zhou, Jessica Q., MD</au><au>Ashley, Euan, MD, DPhil</au><au>Sinagra, Gianfranco, MD</au><au>Schnittger, Ingela, MD</au><au>Knowles, Joshua W., MD, PhD</au><au>Fearon, William F., MD</au><au>Haddad, Francois, MD</au><au>Tremmel, Jennifer A., MD, MS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and Prognostic Role of Right Ventricular Involvement in Stress-Induced Cardiomyopathy</atitle><jtitle>Journal of cardiac failure</jtitle><addtitle>J Card Fail</addtitle><date>2015-05-01</date><risdate>2015</risdate><volume>21</volume><issue>5</issue><spage>419</spage><epage>425</epage><pages>419-425</pages><issn>1071-9164</issn><eissn>1532-8414</eissn><abstract>Abstract Background Stress-induced cardiomyopathy (SCM) is a reversible cardiomyopathy observed in patients without significant coronary disease. The aim of this study was to assess the incidence and clinical significance of right ventricular (RV) involvement in SCM. Methods and Results We retrospectively analyzed echocardiograms from 40 consecutive patients who presented with SCM at Stanford University Medical Center from September 2000 to November 2010. The primary end point was overall mortality. RV involvement was observed in 20 patients (50%; global RV hypokinesia in 15 patients and focal RV apical akinesia in 5 patients). The independent correlates of RV involvement were older age (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.02–1.7two, P = .01) and LVEF (per 10% decrease: OR 3.60, CI 1.77–7.32; P = .02). At a mean follow-up of 44 ± 32 months, 12 patients (30%) died (in-hospital death in 3 patients). At multivariate analysis, the presence of an RV fractional area change <35% emerged as an independent predictor of death (OR 3.6, CI 1.06–12.41; P = .04). Conclusions RV involvement is a common finding in SCM, and may present as either global or focal RV apical involvement. Both older age and lower LVEF are associated with a higher risk of RV involvement, which appears to be a major predictor of death.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25704104</pmid><doi>10.1016/j.cardfail.2015.02.001</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Cardiovascular Cohort Studies echocardiography Female Humans Male Middle Aged Prevalence Prognosis Retrospective Studies right ventricle Stress cardiomyopathy Stroke Volume - physiology Takotsubo Cardiomyopathy - diagnosis Takotsubo Cardiomyopathy - epidemiology Takotsubo Cardiomyopathy - physiopathology Ventricular Dysfunction, Right - diagnosis Ventricular Dysfunction, Right - epidemiology Ventricular Dysfunction, Right - physiopathology |
| title | Prevalence and Prognostic Role of Right Ventricular Involvement in Stress-Induced Cardiomyopathy |
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