Abstract 15287: Atypical Stress Cardiomyopathy is Associated With Lower Risk of Severe Shock at Diagnosis
Introduction: Typical stress cardiomyopathy is characterized by apical ballooning with relative preservation of basal segments. However, atypical variants with variable wall motion abnormalities (WMA) are increasingly recognized. Whether patients presenting with atypical variants of stress cardiomyopathy have distinctive clinical outcomes remains largely unknown.
Hypothesis: Atypical variants of stress cardiomyopathy are associated with a more favorable hemodynamic status and lower mortality compared to the typical form.
Methods: The study included all adult subjects diagnosed with stress cardiomyopathy (Mayo Clinic criteria) at a large medical center between 2005 and 2015. Atypical variants were defined by a midventricular, basal, and/or focal distribution of WMA. The primary outcome was death within 30 days of index diagnosis. Severe shock at diagnosis, defined as the need for vasopressors or mechanical circulatory support, was assessed as the secondary outcome.
Results: Three hundred and six subjects met the inclusion criteria, Table 1. Death and severe shock occurred in in 43 (14%) and 90 (29%) of subjects, respectively. In multivariable logistic regression adjusting for age, Charlson Comorbidity Index, triggering mechanism, sepsis, and initial ejection fraction, atypical variants were not associated with 30-day mortality (OR=0.35, 95% CI=0.09-1.35, p=0.128). However, atypical stress cardiomyopathy was associated with lower odds of severe shock (OR=0.37, 95% CI=0.15-0.95, p=0.039).
Conclusions: Atypical variants of stress cardiomyopathy may be associated with lower likelihood of severe shock at diagnosis.
Table 1. Clinical characteristics.
Data are presented as median (IQR) for continuous variables and count (percentage) for categorical variables. N represents the number of non-missing values.
a Wilcoxon Rank Sum test
b Pearson’s Chi-Squared test
Author Disclosures: A. Nayeri: None. N. Bhatia: None. E. Farber-Eger: None. M. Blair: None. Q. Wells: None.
- © 2016 by American Heart Association, Inc.