Clinical characteristics and outcome of left ventricular ballooning syndrome in a European population

Mario Previtali, Alessandra Repetto, Rita Camporotondo, Rodolfo Citro, Pompilio Faggiano, Daniella Bovelli, Elisabetta Baldini, Giampaolo Pasquetto, Luigi Ascione, Luigi Vignali, Roberta Rosso, Giorgio Baralis, Marco L. Rossi, Marco Ferlini, Eduardo Bossone, Claudio Panciroli, Francesco Della Rovere, Luigi Oltrona Visconti, Catherine Klersy

Research output: Contribution to journalArticlepeer-review

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

Original languageEnglish
Pages (from-to)120-125
Number of pages6
JournalThe American Journal of Cardiology
Volume107
Issue number1
DOIs
Publication statusPublished - Jan 2011

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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