Abstract 2051: Long-Term Clinical Follow-Up of Patients with Transient Left Ventricular Apical Ballooning.
Objectives: Although several cases about transient left ventricular (LV) apical ballooning have been reported, a little is known about long-term outcomes of patients with transient LV apical ballooning. We tried to evaluate its impact on survival.
Methods: To examine long-term (5 to 10 years) clinical outcomes, clinical follow-up information was analyzed in 41 consecutive patients with transient LV apical ballooning in our hospital from Dec.1995 to Dec.2000. We analyzed all patients (17 men and 24 women), aged 62 ± 18 years, who fulfilled the following criteria:
transient LV apical ballooning in left ventriculography (LVG)
no significant angiographic coronary stenosis and
no history of myocardial infarction and cardiomyopathy.
Results: Emotional and physical stress observed in 24 patients (59%). Coronary angiography and LVG were performed in all patients during the acute phase. Of all patients, 2 patients (5%) died during the hospitalization. The reasons of in-hospital death were pneumonia and cardiogenic shock. A total of 39 patients who were discharged alive constituted the study population for long-term outcomes. Clinical follow-up information was obtained in all patients. During the follow-up period, 10 patients (26%) died, 3 patients (8%) were re-hospitalized by heart failure. Of the 3 patients with heart failure, 1 patient (3%) recognized the recurrence of transient LV apical ballooning. The causes of death were malignancy (3 patients), pneumonia (2 patients), aging (2 patients) stroke (1 patient) and unknown (2 patients). Kaplan-Meyer survival curve showed that freedom from all death was 97% (1 years), 90% (3 years), 84% (5 years) and 80% (8 years). Using multivariate analysis of various factors that may have affected mortality, age (Hazard ratio 1.2, 95% confidence interval 1.1 to 1.4, p=0.005) and cardiogenic shock (Hazard ratio 7.1, 95% confidence interval 5 to 9062, p=0.005) were identified as predictors.
Conclusions: The survival of patients with transient LV apical ballooning was favorable except for patients with cardiogenic shock during the acute phase. Age and cardiogenic shock were identified as independent predictors in overall survival.