title: Prevalence and Risk Factors of Stress Cardiomyopathy After Convulsive Status Epilepticus in ICU Patients.
abstract: OBJECTIVE
  Although stress cardiomyopathy has been described in association with epilepsy, its frequency in patients with convulsive status epilepticus remains unknown. Accordingly, we sought to determine the prevalence and risk factors of stress cardiomyopathy in patients admitted to the ICU for convulsive status epilepticus.
  
  
  METHODS
  Prospective, descriptive, single-center study.
  
  
  METHODS
  Medical-surgical ICU of a teaching hospital.
  
  
  METHODS
  Thirty-two consecutive ventilated patients (21 men; age, 50 ± 18 yr; Simplified Acute Physiology Score II, 53 ± 15; Sequential Organ Failure Assessment, 6 ± 2) hospitalized in the ICU for convulsive status epilepticus.
  
  
  METHODS
  None.
  
  
  RESULTS
  Hemodynamic parameters, transthoracic echocardiography, biological data, and electrocardiogram were obtained serially on ICU admission (H0), and after 6, 12, 24, and 48 hours of hospitalization (H6, H12, H24, and H48). Stress cardiomyopathy was defined as a 20% decrease in left ventricular ejection fraction between H0 or H6 and H48. Stress cardiomyopathy was diagnosed in 18 patients (56%; 95% CI, 38-74%). Mean left ventricular ejection fraction, left ventricular stroke index and cardiac index were initially (at H0 or H6 according to lowest individual values) significantly reduced in stress cardiomyopathy patients (45 ± 14% vs 61 ± 6%, p < 0.001; 24 ± 8 vs 28 ± 8 mL/m(2), p < 0.05; 2.3 ± 0.7 vs 3.0 ± 0.8 L/min/m(2), p < 0.05, respectively) and increased secondarily to reach similar mean values than those observed in patients without transient left ventricular dysfunction at H24. Dobutamine was more frequently used in patients with stress cardiomyopathy. Mean lactate level was increased and significantly higher in stress cardiomyopathy patients at H0 and H6, whereas mean central venous oxygen saturation was preserved but significantly lower in this group. Only three patients with stress cardiomyopathy had left ventricular regional wall motion abnormalities but normal coronary angiography. Risk factors of stress cardiomyopathy were age and Simplified Acute Physiology Score II.
  
  
  CONCLUSIONS
  These results suggest that stress cardiomyopathy is common in patients admitted to the ICU for convulsive status epilepticus. Accordingly, these patients should be screened for stress cardiomyopathy and monitored if they present with hemodynamic compromise.
authors.affiliation: 1Medical-Surgical ICU, Félix Guyon Hospital, Teaching Hospital of La Réunion, Saint Denis, France. 2Department of Biostatistics, Félix Guyon Hospital, Teaching Hospital of La Réunion, Saint Denis, France. 3Medical-Surgical ICU, Teaching Hospital of Limoges, Limoges, France. 4INSERM CIC1435, Limoges, France. 5University of Limoges, Limoges, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Belcour
authors.forename: Julien
authors.initials: J
authors.lastname: Jabot
authors.forename: Benjamin
authors.initials: B
authors.lastname: Grard
authors.forename: Arnaud
authors.initials: A
authors.lastname: Roussiaux
authors.forename: Cyril
authors.initials: C
authors.lastname: Ferdynus
authors.forename: David
authors.initials: D
authors.lastname: Vandroux
authors.forename: Philippe
authors.initials: P
authors.lastname: Vignon
mesh_terms: D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013226:Status Epilepticus / Q000150:complications*; D054549:Takotsubo Cardiomyopathy / Q000453:epidemiology* / Q000209:etiology*