title: Clinical characteristics and outcome of left ventricular ballooning syndrome in a European population.
abstract: We assessed the clinical characteristics and determinants of the prognosis of patients with left ventricular ballooning syndrome (LVBS) in an European population. A total of 128 patients with LVBS (98% women, age 67 ± 11 years) were prospectively followed up for a median of 13 months. A trigger event was identifiable in 58% of the patients. Anterior ST-segment elevation was documented in 38% and negative T waves in 41% of the patients. Apical ballooning was present in 82% and midventricular ballooning in 18%. The initial LV ejection fraction was 41 ± 9%. In-hospital events included the death of 1 patient (0.8%), LV failure in 13 (10%), LV thrombi in 4 (3.1%), sustained ventricular or supraventricular tachyarrhythmias in 6 (4.7%) and asystole in 2 patients (1.6%). The extent of wall motion abnormalities (odds ratio 4.16, p = 0.012), dyspnea at presentation (odds ratio 3.42, p = 0.01), and treatment with nitrates (odds ratio 0.30, p = 0.015) were significant univariate predictors of in-hospital events. The recovery of regional wall motion abnormalities occurred within 1 month of the event in 73% of patients. During follow-up, events occurred in 7 (6%) of 121 patients, including noncardiac death in 1 (0.8%), recurrent LVBS in 2 (1.6%), heart failure in 1 (0.8%), and recurrent chest pain in 3 (2.5%). In conclusion, in a European population, LVBS was characterized by a significant rate of in-hospital events, mainly related to pump failure, and low short-term mortality. The extent of wall motion abnormalities was the best predictor of acute events. Contractile recovery occurred within 1 month in most patients. The long-term prognosis was good, with a recurrence rate of <2%/year.
authors.affiliation: Department of Cardiology, IRCCS Fondazione Policlinico San Matteo, University of Pavia School of Medicine, Pavia, Italy. m.previtali@smatteo.pv.it
authors.forename: Mario
authors.initials: M
authors.lastname: Previtali
authors.forename: Alessandra
authors.initials: A
authors.lastname: Repetto
authors.forename: Rita
authors.initials: R
authors.lastname: Camporotondo
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Citro
authors.forename: Pompilio
authors.initials: P
authors.lastname: Faggiano
authors.forename: Daniella
authors.initials: D
authors.lastname: Bovelli
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Baldini
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Pasquetto
authors.forename: Luigi
authors.initials: L
authors.lastname: Ascione
authors.forename: Luigi
authors.initials: L
authors.lastname: Vignali
authors.forename: Roberta
authors.initials: R
authors.lastname: Rosso
authors.forename: Giorgio
authors.initials: G
authors.lastname: Baralis
authors.forename: Marco L
authors.initials: ML
authors.lastname: Rossi
authors.forename: Marco
authors.initials: M
authors.lastname: Ferlini
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
authors.forename: Claudio
authors.initials: C
authors.lastname: Panciroli
authors.forename: Francesco Della
authors.initials: FD
authors.lastname: Rovere
authors.forename: Luigi Oltrona
authors.initials: LO
authors.lastname: Visconti
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology