Impact of ventricular tachyarrhythmia on in-hospital outcome in patients with stress-induced cardiomyopathy

초록

Background: Although stress-induced cardiomyopathy (SCMP) shows relatively favorable outcome, there were some reports that ventricular tachycardia/fibrillation (VT/VF) were developed in SCMP patients. However, it is unknown about the clinical impact on in-hospital outcome of ventricular tachyarrhythmia developed in SCMP patients. Hypothesis: VT/VF developed in SCMP patients might be associated with poor in-hospital outcome. Methods: This study was conducted as a multicenter, retrospective, observational study of 232 SCMP patients. All patients underwent electrocardiography (ECG), transthoracic echocardiography, blood chemistry, and coronary angiography. Clinical data were reviewed from medical records and telephone interviews Results: There were no significant differences between VT/VF group (13/232, 5.6%) and non-VT/VF group (219/232, 94.4%) with respect to demographic data, prevalence of coronary artery disease (CAD) and risk factors of CAD, cardiac enzyme, the percentage of preceding stressor type (emotional vs physical), and in-hospital mortality (15.4% vs 10%, p=0.397). However, VT/VF group had a higher percentage of shock (46.2% vs 11.7%, p=0.003), use of inotropics (76.9% vs 26.6%, p=0.000), and mechanical ventilation (46.2% vs 20.6%, p=0.042). Low left ventricular ejection fraction (LVEF) (31±13% vs 41±12%, p=0.006) and prolonged QTc (559±61ms vs 515±69ms, p=0.042) were correlated with VT/VF as well. Conclusion: VT/VF developed in SCMP patients was not correlated with the in-hospital mortality although it was more common in SCMP patients with hemodynamic instability, decreased LV systolic function, or respiratory failure requiring mechanical ventilation.