Portal de Periódicos da CAPES

Prevalence and Prognostic Role of Right Ventricular Involvement in Stress-Induced Cardiomyopathy

2015; Elsevier BV; Volume: 21; Issue: 5 Linguagem: Inglês

10.1016/j.cardfail.2015.02.001

1532-8414

Gherardo Finocchiaro, Yukari Kobayashi, Emma Magavern, Jessica Zhou, Euan A. Ashley, Gianfranco Sinagra, Ingela Schnittger, Joshua W. Knowles, William F. Fearon, François Haddad, Jennifer A. Tremmel,

Pericarditis and Cardiac Tamponade

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.