Submit Manuscripts
Author Information
Subscribe/Renew
Email Alerts
Feedback
RSS Feed

About the Journal
Editorial Board & Staff

Interventions Homepage Imaging Homepage Interventions Homepage Imaging Homepage

ACC.org
Cardiosmart
Cardiosource
CVN
Imaging Library
JACC Imaging
JACC Interventions

ACC/AHA 2008 Performance Measures for Adults With ST-Elevation and Non–ST-Elevation Myocardial Infarction

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease
cardiology careers collections past issues search home
     

J Am Coll Cardiol, 2007; 49:921, doi:10.1016/j.jacc.2006.12.004 (Published online 8 February 2007).
© 2007 by the American College of Cardiology Foundation
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2006.12.004v1
49/8/921    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sharkey, S. W.
Right arrow Articles by Maron, B. J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Sharkey, S. W.
Right arrow Articles by Maron, B. J.
Related Collections
Right arrowRelated Articles

CORRESPONDENCE: LETTERS TO THE EDITOR

Stress Cardiomyopathy

Scott W. Sharkey, MD, FACC*, John R. Lesser, MD, FACC, Martin S. Maron, MD and Barry J. Maron, MD, FACC

* Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 60, Minneapolis, Minnesota 55407 (Email: scott.sharkey{at}allina.com).

We were interested to see the report of Hurst et al. (1) describing 4 women with stress (tako-tsubo) cardiomyopathy and systolic "midventricular ballooning." As noted by the investigators, this left ventricular (LV) contraction pattern differs from that of many other patients with stress cardiomyopathy because the distal portion of the chamber at the LV apex demonstrates a normal contraction pattern (apical sparing). Indeed, in our initial report of women with stress cardiomyopathy we also reported normal contraction of the apical LV segment in 9 of 22 patients (41%) based on cardiac magnetic resonance imaging (MRI) (2). In addition, Abdulla et al. (3) also recently reported apical sparing in 14 of 35 patients (40%) with stress cardiomyopathy. Therefore, this particular reversible pattern of abnormal LV contraction is very common in stress cardiomyopathy, and it may well have been an overestimation on the part of Hurst et al. (1) to regard this form of the condition as a novel variant.

Conversely, such patients clearly represent a subset within this disease spectrum, although of uncertain mechanism and clinical significance at this time. This diversity of phenotypic expression would, however, underscore the superiority of the term "stress cardiomyopathy" to describe this diverse entity rather than the ultimately confusing "midventricular ballooning" or "apical ballooning syndrome" (4–6). At this relatively early juncture in the evolving description of stress cardiomyopathy, application of clear and consistent nomenclature seems essential.


   References
Top
 References
 

  1. Hurst RT, Askew JW, Reuss CS, et al. Transient midventricular ballooning syndrome: a new variant J Am Coll Cardiol 2006;48:579-583.[Abstract/Free Full Text]
  2. Sharkey SW, Lesser JR, Zenovich AG, et al. Acute and reversible cardiomyopathy provoked by stress in women from the United States Circulation 2005;111:472-479.
  3. Abdulla I, Kay S, Mussap C, et al. Apical sparing in tako-tsubo cardiomyopathy Intern Med J 2006;36:414-418.[CrossRef][ISI][Medline]
  4. Bybee KA, Kara T, Prasad A, et al. Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction Ann Intern Med 2004;141:858-865.[Abstract/Free Full Text]
  5. Tsuchihashi K, Ueshima K, Uchida T, et al. Transient left ventricular apical ballooning without coronary artery stenosis: a novel heart syndrome mimicking acute myocardial infarctionAngina Pectoris-Myocardial Infarction Investigations in Japan. J Am Coll Cardiol 2001;38:11-18.[Abstract/Free Full Text]
  6. Park JH, Kang SJ, Song JK, et al. Left ventricular apical ballooning due to severe physical stress in patients admitted to the medical ICU Chest 2005;128:296-302.

Related Articles

Stress Cardiomyopathy
Scott W. Sharkey, John R. Lesser, Martin S. Maron, and Barry J. Maron
J. Am. Coll. Cardiol. 2007 49: 921. [Full Text] [PDF]

Reply
R. Todd Hurst, Christina S. Reuss, A. Jamil Tajik, and J. Wells Askew
J. Am. Coll. Cardiol. 2007 49: 921-922. [Full Text] [PDF]




This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2006.12.004v1
49/8/921    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via ISI Web of Science (1)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sharkey, S. W.
Right arrow Articles by Maron, B. J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Sharkey, S. W.
Right arrow Articles by Maron, B. J.
Related Collections
Right arrowRelated Articles
 
  cardiology careers collections past issues search home