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ȣ - 520736 377 |
| Clinical Characteristics of Typical Vs. Atypical Stress-Induced Cardiomyopathy |
| 연세대학교 영동세브란스병원 순환기내과 |
| 심우호, 문희선, 이기병, 김원호, 박상민, 윤영원, 민필기, 홍범기, 임세중, 권혁문 |
Background : Apical ballooning has been a typical finding of stress-induced cardiomyopathy (SCM), but the presence of atypical type, in which other regions of left ventricle except apex are involved, is now being reported. We evaluated the clinical characteristics of two types of SCM.
Methods and Results : A retrospective review was conducted of 25 patients who were properly diagnosed as SCM by the definition, and divided into ‘typical’(n=18) and 'atypical’(n=7) types according to location of decreased regional wall motion on echocardiography. Demographic features, ECG change, and echocardiographic findings were analyzed, and are shown in two tables as below.
Conclusions : There was no significant difference of baseline clinical characteristics except cardiac enzyme levels between typical and atypical SCM. Additionally, this analysis showed a trend of time discrepancy between mechanical and electrical restoration in typical SCM, but not in atypical SCM. Future study will be warranted in larger number of patients.
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Table1. Baseline Demographic Characteristics
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Typical SCM (n=18) |
Atypical SCM (n=7) |
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Age (years old) |
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63.9 ± 16.1 |
64.3 ± 6.9 |
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Sex (female) |
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14/18 (78%) |
5/7 (71%) |
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Stress |
Emotional/Physical |
3 / 12 (17%/66%) |
1/6 (14%/86%) |
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EKG changes1 |
Yes / No |
15/3 (83%/17%) |
5/2 (71%/29%) |
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Initial LVEF2 (%) |
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28 ± 13 |
32 ± 8 |
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Cardiac enzymes |
CK-MB (ng/mL) |
23.99 ± 23.33* |
6.17 ± 4.08* |
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Troponin T (ng/mL) |
0.96 ± 1.20** |
0.14 ± 0.15** |
1 : Including ST-segment/T-wave changes and/or QTc prolongation, 2 Left ventricular ejection fraction
*, ** : significant(p<0.05) compared with typical and atypical SCM
Table2. Normalization of ECG changes and LVEF as Times
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Weeks after diagnosis |
Typical SCM* |
Atypical SCM* |
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ECG changes |
1 |
2/13 (15%)1 |
2/6 (33%)1 |
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2 |
4/10 (40%)2 |
4/5 (80%)2 |
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3 |
5/10 (50%)3 |
5/5 (100%)3 |
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LVEF |
1 |
4/15 (27%) |
4/7 (57%) |
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2 |
12/15 (80%) |
6/7 (86%) |
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3 |
12/15 (80%) |
6/7 (86%) |
* Recorded as accumulated values
1,2,3 : no statistically significant difference
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