Differences in Initial Electrocardiographic Findings of Apical Takotsubo Syndrome According to the Time from Symptom Onset - 19/11/18
, Tsutomu Yoshikawa, MD, PhD a, Tetsuo Yamaguchi, MD, PhD a, Kenshiro Arao, MD, PhD a, Tetsuro Ueda, MD, PhD a, Yoichi Imori, MD a, Yuichiro Maekawa, MD, PhD a, Tsutomu Murakami, MD, PhD a, Takeshi Yamamoto, MD, PhD a, Ken Nagao, MD, PhD a, Morimasa Takayama, MD, PhD aRésumé |
No previous study has examined the differences in patient characteristics and initial electrocardiographic findings of Takotsubo syndrome (TTS) according to the time from onset to electrocardiography. Using the Tokyo Cardiovascular Care Unit network registry 2011-2012, we retrospectively identified 106 apical TTS patients in whom symptom onset time was specified, and classified the patients into 5 groups according to the time from onset to the initial electrocardiography: <3 hours (n = 45), 3 to 6 hours (n = 20), 6 to 12 hours (n = 12), 12 to 24 hours (n = 13), and ≥24 hours (n = 16). There was no significant difference across the groups in age, gender, symptoms, triggers, vital signs, blood tests, or in-hospital outcomes. In the electrocardiographic findings, ST-elevation was more frequent in leads V2-V4 than in the other leads, especially in the <24 hour groups, but did not differ significantly across groups. T-wave inversion was more frequent in leads V3-V6, especially in the ≥24 hour group, and differed significantly across groups. The total number of leads with T-wave inversion was significantly larger in the ≥24 hour group than in the <24 hour groups (mean, 5.9 leads vs 1.5 to 2.9 leads; p < 0.001). Isolated ST-elevation was the most frequent pattern of ST-T change in precordial leads (42% to 56%) in the <24 hour groups, while isolated T-wave inversion was the most frequent (44%) in the ≥24 hour group (p = 0.018). Neither ST-elevation nor T-wave inversion was observed in precordial leads in 10 (9%) patients. In conclusion, our results suggest that the initial electrocardiographic findings of apical TTS are affected by the time from onset to electrocardiography and display a wide variation in ST-T changes.
Le texte complet de cet article est disponible en PDF.Plan
Vol 122 - N° 10
P. 1630-1637 - novembre 2018 Retour au numéro
Article précédent
- Usefulness of Cardiac Magnetic Resonance Imaging in Patients With Acute Spontaneous Coronary Artery Dissection
- Nicholas Y. Tan, Sharonne N. Hayes, Phillip M. Young, Rajiv Gulati, Marysia S. Tweet
- Dual Antiplatelet Therapy Cessation and Adverse Events After Drug-Eluting Stent Implantation in Patients at High Risk for Atherothrombosis (from the PARIS Registry)
- Sabato Sorrentino, Gennaro Giustino, Usman Baber, Samantha Sartori, David J. Cohen, Timothy D. Henry, Serdar Farhan, Madhav Sharma, Cono Ariti, George Dangas, Michael Gibson, Michela Faggioni, Mitchell W. Krucoff, Melissa Aquino, Jaya Chandrasekhar, David J. Moliterno, Antonio Colombo, Birgit Vogel, Alaide Chieffo, Annapoorna S. Kini, Bernhard Witzenbichler, Giora Weisz, Philippe Gabriel Steg, Stuart Pocock, Roxana Mehran
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?