RT Journal Article
T1 Clinical and prognostic comparison between left ventricular transient dyskinesia and a first non-ST-segment elevation acute coronary syndrome
A1 Núñez Gil, Iván Javier
A1 Fernández Ortiz, Antonio Ignacio
A1 Pérez De Isla, Leopoldo
A1 Luaces Méndez, María
A1 García Rubira, Juan Carlos
A1 Vivas Balcones, Luis David
A1 González Armengol, Juan Jorge
A1 Alonso, Joaquín
A1 Zamorano Gómez, José Luis
A1 Macaya Miguel, Carlos
AB Objectives: Apical ballooning shares features with acute coronary syndromes. Recently, atypical forms have been reported without apical involvement. Usually, the prognostic reports have compared them with ST-segment elevation infarction. Left ventricular transient dyskinesias (LVTD), however, frequently occur without ST-segment elevation and when present, these patients always have open arteries. Our aim was to assess the baseline features, clinical presentation, natural history and compare long-term prognosis in an LVTD-cohort with a first non-ST-segment elevation acute coronary syndrome (NSTEMI) group.Methods: We performed a prospective observational study including consecutive patients in two groups: (i) LVTD group: 62 patients with this syndrome between 2003 and 2007. Inclusion criteria were LV segmental transient motion abnormalities; ECG new alterations and elevated troponin; absence of recent significant head trauma or obstructive coronary artery lesions. (ii)Control group: 169 patients admitted for a first NSTEMI in 2004.Results: Median follow-up was 35 months. Mean age was 65 years. LVTD group included 83.9% females. NSTEMI group was predominantly males. Eleven in-hospital deaths happened in NSTEMI cohort and none in LVTD. Four patients in the LVTD group required readmission and two patients died. In the NSTEMI group, heart failure, unstable angina, myocardial infarction (P<0.001) and death (P=0.11) were more frequent. Cox regression showed that diabetes mellitus, significant onset mitral regurgitation and NSTEMI versus LVTD were found as event-independent predictors.Conclusion: LVTD diagnosis represents a decreased risk of events when compared with classic non-ST-segment acute coronary syndrome, pointing out a different pathophysiologic mechanism.
PB Lippincott, Williams & Wilkins
SN 0954-6928
YR 2008
FD 2008
LK https://hdl.handle.net/20.500.14352/101145
UL https://hdl.handle.net/20.500.14352/101145
LA eng
NO Núñez-Gil IJ, Fernández-Ortiz A, Pérez-Isla L, Luaces M, García-Rubira JC, Vivas D, Gonzalez JJ, Alonso J, Zamorano JL, Macaya C. Clinical and prognostic comparison between left ventricular transient dyskinesia and a first non-ST-segment elevation acute coronary syndrome. Coron Artery Dis. 2008 Nov;19(7):449-53. doi: 10.1097/MCA.0b013e32830eab74. PMID: 18923239.
DS Docta Complutense
RD 21 abr 2025