Abstract 18199: Prevalence, Profile and Impact on Clinical Course of Transient Apical Wall Thickening in Patients with Stress Induced Cardiomyopathy
Background: Recently transient apical wall thickening mimicking apical hypertrophic cardiomyopathy have been reported during recovery from stress cardiomyopathy (SCM). However, incidence and outcomes for these patients have not been assessed. We aimed to explore the prevalence, profiles, and impact on clinical course of transient apical wall thickening in patients with SCM.
Methods: We retrospective analyzed SCM registry (Jan 2009 to Dec 2013) and among 429 patients with SCM, 124 patients who had typical echocardiographic features of apical ballooning without significant stenosis on coronary angiogram and fully recovered myocardial function on follow-up echocardiography were selected. Among them, we selected patients with transient apical wall thickening confined predominantly to the LV apex then normalized on serial echocardiograms. Clinical characteristics and incidence of cardiac complications were compared between patients with apical wall thickening and those without.
Results: Among 124 patients, 17 (14%) patients showed transient apical wall thickening. In time sequence, apical wall thickening was observed 15.6 ± 9.9 days after the initial diagnosis of SCM. Patients with transient apical wall thickening showed a higher prevalence of septic shock as a triggering factor of SCM than those without (41.2 vs. 19.6%, p=0.048). Despite a higher LV ejection fraction at the time of diagnosis of SCM (41.6±11.3 vs. 35.5 ± 11.2, p=0.04), cardiac complications were more prevalent in patients with transient apical wall thickening compared to patients without (64.7 vs. 35.5%, p=0.02). In-hospital mortality was higher in patients with apical wall thickening (35.3 vs. 11.2%, p= 0.009, Figure.1).
Conclusion: Transient apical wall thickening in patients with SCM is not uncommon. Patients with SCM in septic condition are susceptible to this finding and showed worse prognosis compare to those without transient apical wall thickening during recovery from SCM.
Author Disclosures: D. Shin: None. I. Cho: None. C. Shim: None. S. Ryu: None. H. Chang: None. G. Hong: None. J. Ha: None. N. Chung: None.
- © 2014 by American Heart Association, Inc.