Transient stress cardiomyopathy (TSC) is a cause of reversible left ventricular (LV)
dysfunction that is increasingly recognized. Reports to date have focused primarily
on LV involvement, with little attention paid to associated right ventricular (RV)
dysfunction. With other forms of LV dysfunction, RV involvement has been shown to
confer an adverse prognosis. Prevalence, clinical characteristics, and short-term
prognosis of RV dysfunction in TSC remain ill-defined. Presenting echocardiograms
of 40 patients with TSC were reviewed. RV function was assessed by evaluating regional
wall motion and calculating a wall motion score index (WMSI). RV dysfunction was defined
as a WMSI >1.0. Clinical and demographic characteristics of patients with and without
RV dysfunction were compared. RV dysfunction was identified in 27% of patients (11
of 40). RV WMSI was 1.20 ± 0.30 for the entire cohort compared with 1.72 ± 0.30 for
those with RV dysfunction (p <0.05). In each case with RV dysfunction, regional wall
motion abnormalities involved the apex and spared the base. Patients with RV dysfunction
had higher B-type natriuretic peptide levels, higher pulmonary artery systolic pressures,
and longer hospital stays. RV dimensions, clinical characteristics, electrocardiographic
findings, other biomarkers, and in-hospital complications were similar. In conclusion,
RV wall motion abnormalities, predominantly involving the apex and sparing the base,
occur in slightly >1/4 of cases of TSC. Although associated with higher B-type natriuretic
peptide levels, higher pulmonary artery systolic pressures, and longer hospital stays,
RV dysfunction was not associated with significant differences in short-term cardiac
morbidity or increased early mortality.
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Article info
Publication history
Published online: May 04, 2009
Accepted:
February 23,
2009
Received in revised form:
February 23,
2009
Received:
November 26,
2008
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
