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 <2%/year.
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Article Info
Publication History
Accepted:
August 17,
2010
Received in revised form:
August 17,
2010
Received:
June 16,
2010
Footnotes
R. Citro is currently with A. O. Universitaria “San Giovanni di Dio e Ruggi d'Aragona,” Salerno, Italy.
M. Ferlini is currently with Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
