TY - JOUR
T1 - Incidence, Clinical Findings, and Outcome of Women With Left Ventricular Apical Ballooning Syndrome
AU - Parodi, Guido
AU - Del Pace, Stefano
AU - Carrabba, Nazario
AU - Salvadori, Claudia
AU - Memisha, Gentian
AU - Simonetti, Ignazio
AU - Antoniucci, David
AU - Gensini, Gian Franco
PY - 2007/1/15
Y1 - 2007/1/15
N2 - Left ventricular apical ballooning syndrome (LVABS) is a clinical condition that may mimic ST-elevation acute myocardial infarction (AMI). To assess incidence, clinical findings, and outcome of white women with LVABS, we reviewed 305 consecutive women with chest pain and anterior ST-elevation AMI referred for potential mechanical revascularization; 36 (12%) patients met the diagnostic criteria for LVABS and were compared with the remaining 269 women with angiographic evidence of coronary artery disease (CAD). Patients with LVABS showed a lower incidence of diabetes mellitus (5% vs 21%, p = 0.023), a higher rate of antecedent stressful events (26% vs 3%, p 50% stenosis) in the 269 control women (p = 0.0001). Peak creatine kinase-MB value was lower in patients with LVABS (21 ± 26 mU/ml) than in women with CAD (307 ± 302 mU/ml, p = 0.0001). The only independent predictors of LVABS among women with anterior AMI were peak creatine kinase-MB value (p = 0.0001) and the presence of an antecedent stressful event (p = 0.001). LV systolic function at admission was similar between women with LVABS and those with CAD (echocardiographic ejection fraction 35.6 ± 8.4% vs 35.5 ± 8.0%, p = 0.944) but was significantly different at discharge (ejection fraction 50.1 ± 9.6% vs 45.2 ± 13.5%, p = 0.021). Moreover, at 6-month follow-up, women with LVABS showed a better survival rate (97% vs 86%, p = 0.055) and freedom from major cardiac events (death, reinfarction, or rehospitalization 92% vs 69%, p = 0.001) than women with CAD. In conclusion, few women presenting with clinical features of anterior AMI have LVABS. Despite a favorable outcome, LVABS should be considered in the differential diagnosis of women with chest pain and ST-segment elevation in the precordial leads. Peak creatine kinase-MB value and the presence of an antecedent stressful event are strong predictors of LVABS in women with anterior AMI.
AB - Left ventricular apical ballooning syndrome (LVABS) is a clinical condition that may mimic ST-elevation acute myocardial infarction (AMI). To assess incidence, clinical findings, and outcome of white women with LVABS, we reviewed 305 consecutive women with chest pain and anterior ST-elevation AMI referred for potential mechanical revascularization; 36 (12%) patients met the diagnostic criteria for LVABS and were compared with the remaining 269 women with angiographic evidence of coronary artery disease (CAD). Patients with LVABS showed a lower incidence of diabetes mellitus (5% vs 21%, p = 0.023), a higher rate of antecedent stressful events (26% vs 3%, p 50% stenosis) in the 269 control women (p = 0.0001). Peak creatine kinase-MB value was lower in patients with LVABS (21 ± 26 mU/ml) than in women with CAD (307 ± 302 mU/ml, p = 0.0001). The only independent predictors of LVABS among women with anterior AMI were peak creatine kinase-MB value (p = 0.0001) and the presence of an antecedent stressful event (p = 0.001). LV systolic function at admission was similar between women with LVABS and those with CAD (echocardiographic ejection fraction 35.6 ± 8.4% vs 35.5 ± 8.0%, p = 0.944) but was significantly different at discharge (ejection fraction 50.1 ± 9.6% vs 45.2 ± 13.5%, p = 0.021). Moreover, at 6-month follow-up, women with LVABS showed a better survival rate (97% vs 86%, p = 0.055) and freedom from major cardiac events (death, reinfarction, or rehospitalization 92% vs 69%, p = 0.001) than women with CAD. In conclusion, few women presenting with clinical features of anterior AMI have LVABS. Despite a favorable outcome, LVABS should be considered in the differential diagnosis of women with chest pain and ST-segment elevation in the precordial leads. Peak creatine kinase-MB value and the presence of an antecedent stressful event are strong predictors of LVABS in women with anterior AMI.
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U2 - 10.1016/j.amjcard.2006.07.080
DO - 10.1016/j.amjcard.2006.07.080
M3 - Article
C2 - 17223415
AN - SCOPUS:33846059237
VL - 99
SP - 182
EP - 185
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 2
ER -