title: Diverse left ventricular morphology and predictors of short-term outcome in patients with stress-induced cardiomyopathy.
abstract: BACKGROUND
  There is paucity of data with regard to the clinical spectrum according to left ventricle (LV) morphological variation in stress-induced cardiomyopathy (SCMP) patients, and still there is controversy in terms of prognosis since some people believe that the published in-hospital mortality data of patients with SCMP are underestimated. Therefore, we sought to investigate the morphological features of LV and in-hospital outcome of patients with SCMP and explored predictors of short-term prognosis.
  
  
  METHODS
  This was a multicenter, observational study of 208 SCMP patients. Morphological features of LV were determined by echocardiography and were divided into typical (apical) and atypical ballooning types, which were subcategorized into mid-LV ballooning and basal 'inverted' ballooning type. All-cause mortality of patients with SCMP during hospitalization was recorded.
  
  
  RESULTS
  The apical ballooning type was most common (67.3%) in SCMP followed by the mid-LV ballooning type (28.3%), and the basal 'inverted' ballooning type (4.3%). There were no differences in stressor types and in-hospital mortality between patients with typical and atypical SCMP. Notably, all the in-hospital mortality of SCMP patients occurred in patients with physical stressors, where age, shock, and LV ejection fraction were the independent risk factors for predicting in-hospital mortality.
  
  
  CONCLUSIONS
  SCMP patients showed diverse patterns of LV morphology, but there were no definite differences on clinical spectrum among SCMP patients presenting various LV morphological patterns. In terms of short-term prognosis, underlying physical conditions combined with old age, hemodynamic compromise, and low LV systolic function might be the most important factors in SCMP patients.
authors.affiliation: Division of Cardiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Kwon
authors.forename: Byung Ok
authors.initials: BO
authors.lastname: Kim
authors.forename: Myung-Hyun
authors.initials: MH
authors.lastname: Kim
authors.forename: Sung-Joo
authors.initials: SJ
authors.lastname: Lee
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Yoon
authors.forename: Hyemoon
authors.initials: H
authors.lastname: Chung
authors.forename: Chi-Young
authors.initials: CY
authors.lastname: Shim
authors.forename: Duk Kyu
authors.initials: DK
authors.lastname: Cho
authors.forename: Sung Kee
authors.initials: SK
authors.lastname: Ryu
authors.forename: Se-Jung
authors.initials: SJ
authors.lastname: Yoon
authors.forename: Young Won
authors.initials: YW
authors.lastname: Yoon
authors.forename: Hyuk-Jae
authors.initials: HJ
authors.lastname: Chang
authors.forename: Se-Joong
authors.initials: SJ
authors.lastname: Rim
authors.forename: Hyuck Moon
authors.initials: HM
authors.lastname: Kwon
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Bum-Kee
authors.initials: BK
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D056910:Republic of Korea / Q000453:epidemiology; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging* / Q000401:mortality*; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult