title: Stress-induced cardiomyopathy in Sweden: evidence for different ethnic predisposition and altered cardio-circulatory status.
abstract: BACKGROUND
  In this paper, we report about new insights regarding clinical course, long-term outcome, ethnic/genetic predisposition and cardio-circulatory status in the large stress-induced cardiomyopathy (SIC) cohort from Sweden.
  
  
  RESULTS
  We have included 115 consecutive SIC patients between January 2005 and January 2010 at Sahlgrenska University Hospital in Gothenburg. Hemodynamic status and sympathetic nerve activity were evaluated and compared with those of healthy controls. Mean age was 64, and 14% were males. Thirty-day and 3-year mortality was 6 and 10%, respectively. Eleven percent had ischemic heart disease, 3% developed thromboembolic complications, 6% had cardiac arrest and 14% developed cardiogenic shock. The great majority of SIC patients (93%) were ethnic Swedes. In three families, several close relatives developed SIC. Fourteen percent developed two or more episodes of SIC. Hemodynamic evaluation has shown subnormal systemic vascular resistance, 22% lower sympathetic activity and preserved cardiac output in SIC patients.
  
  
  CONCLUSIONS
  SIC affects both men and women of different ages and is associated with significant short- and long-term mortality. There is a strong signal for the presence of ethnic/genetic predisposition to develop SIC. Sympathetic activity and systemic vascular resistance are lower in SIC patients, suggesting that SIC is a cardio-circulatory phenomenon.
authors: Department of Molecular and Clinical Medicine at Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: Tomas
authors: T
authors: Schultz
authors: Yangzhen
authors: Y
authors: Shao
authors: Björn
authors: B
authors: Redfors
authors: Yrsa Bergmann
authors: YB
authors: Sverrisdóttir
authors: Truls
authors: T
authors: Råmunddal
authors: Per
authors: P
authors: Albertsson
authors: Göran
authors: G
authors: Matejka
authors: Elmir
authors: E
authors: Omerovic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003326:Coronary Circulation / Q000502:physiology; D005260:Female; D020022:Genetic Predisposition to Disease; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D013564:Sympathetic Nervous System / Q000502:physiology; D054549:Takotsubo Cardiomyopathy / Q000208:ethnology* / Q000235:genetics / Q000503:physiopathology; D055815:Young Adult