The early dynamic of ECG in Takotsubo syndrome presenting with ST-elevation : A comparison with age and gender-matched ST-elevation myocardial infarction
Copyright © 2020. Published by Elsevier B.V..
BACKGROUND: Takotsubo syndrome mimics acute myocardial infarction (MI) at presentation.
OBJECTIVES: To explore differences in ECG time-course that could further help distinguish the two conditions.
METHODS: Serial ECG's (day 0-4) of 27 acute takotsubo and 37 MI patients, all presenting with anterior ST-elevation, were analysed for detailed morphology and timing of de/re-polarisation. All underwent cardiac magnetic resonance.
RESULTS: The presenting ECG (day 0) showed significantly fewer total abnormal leads (p = .001), comparable number of ST-elevation leads but lesser total magnitude of ST-elevation (p = .003), smaller sum of positive T wave amplitude (p = .006) and lesser number of pathological Q waves (p = .005) in takotsubo vs the MI group. After day 0, takotsubo patients developed more widespread T wave inversion (p = .001, day 3) and/or deeper T waves compared to MI, (sum of the T-wave amplitude slope of change between days 0-3: -43.1 ± 9.6 vs - 16.6 ± 5.4 mm, p = .02). Although there was no difference in mean QTc between the groups on any day, between days 0-3 there was a progressive increase in QTc in takotsubo vs a decrease in MI (34.1 ± 12.2 vs -29.5 ± 9.3 ms, slope of change p < .001). There was significantly more myocardial oedema (native T1 mapping) in takotsubo vs MI (p = .02), which resulted in increased left ventricular mass index in takostubo (p = .04).
CONCLUSIONS: The differences in presenting (day 0) ECG between takotsubo and MI are significant but subtle, reinforcing the importance of acute cardiac catheterisation for accurate diagnosis. During the next 3 days there is progressive increase in the depth and spread of T-waves and QTc duration in takotsubo vs MI - these may aid the diagnostic confidence in patients with bystander non-obstructive coronary disease.
| Errataetall: |
CommentIn: Int J Cardiol. 2021 Feb 1;324:22. - PMID 32810545 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:320 |
|---|---|
| Enthalten in: |
International journal of cardiology - 320(2020) vom: 01. Dez., Seite 7-11 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Scally, Caroline [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 14.05.2021 Date Revised 26.05.2021 published: Print-Electronic CommentIn: Int J Cardiol. 2021 Feb 1;324:22. - PMID 32810545 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.ijcard.2020.07.025 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM312784279 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM312784279 | ||
| 003 | DE-627 | ||
| 005 | 20231225145146.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ijcard.2020.07.025 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1042.xml |
| 035 | |a (DE-627)NLM312784279 | ||
| 035 | |a (NLM)32702407 | ||
| 035 | |a (PII)S0167-5273(20)33473-2 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Scally, Caroline |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The early dynamic of ECG in Takotsubo syndrome presenting with ST-elevation |b A comparison with age and gender-matched ST-elevation myocardial infarction |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 14.05.2021 | ||
| 500 | |a Date Revised 26.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Int J Cardiol. 2021 Feb 1;324:22. - PMID 32810545 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020. Published by Elsevier B.V. | ||
| 520 | |a BACKGROUND: Takotsubo syndrome mimics acute myocardial infarction (MI) at presentation | ||
| 520 | |a OBJECTIVES: To explore differences in ECG time-course that could further help distinguish the two conditions | ||
| 520 | |a METHODS: Serial ECG's (day 0-4) of 27 acute takotsubo and 37 MI patients, all presenting with anterior ST-elevation, were analysed for detailed morphology and timing of de/re-polarisation. All underwent cardiac magnetic resonance | ||
| 520 | |a RESULTS: The presenting ECG (day 0) showed significantly fewer total abnormal leads (p = .001), comparable number of ST-elevation leads but lesser total magnitude of ST-elevation (p = .003), smaller sum of positive T wave amplitude (p = .006) and lesser number of pathological Q waves (p = .005) in takotsubo vs the MI group. After day 0, takotsubo patients developed more widespread T wave inversion (p = .001, day 3) and/or deeper T waves compared to MI, (sum of the T-wave amplitude slope of change between days 0-3: -43.1 ± 9.6 vs - 16.6 ± 5.4 mm, p = .02). Although there was no difference in mean QTc between the groups on any day, between days 0-3 there was a progressive increase in QTc in takotsubo vs a decrease in MI (34.1 ± 12.2 vs -29.5 ± 9.3 ms, slope of change p < .001). There was significantly more myocardial oedema (native T1 mapping) in takotsubo vs MI (p = .02), which resulted in increased left ventricular mass index in takostubo (p = .04) | ||
| 520 | |a CONCLUSIONS: The differences in presenting (day 0) ECG between takotsubo and MI are significant but subtle, reinforcing the importance of acute cardiac catheterisation for accurate diagnosis. During the next 3 days there is progressive increase in the depth and spread of T-waves and QTc duration in takotsubo vs MI - these may aid the diagnostic confidence in patients with bystander non-obstructive coronary disease | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Choo, WaiKah |e verfasserin |4 aut | |
| 700 | 1 | |a Rudd, Amelia |e verfasserin |4 aut | |
| 700 | 1 | |a Neil, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Siddiqi, Nishat |e verfasserin |4 aut | |
| 700 | 1 | |a Mezincescu, Alice M |e verfasserin |4 aut | |
| 700 | 1 | |a Wilson, Heather M |e verfasserin |4 aut | |
| 700 | 1 | |a Frenneaux, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Horgan, Graham |e verfasserin |4 aut | |
| 700 | 1 | |a Broadhurst, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Dawson, Dana K |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t International journal of cardiology |d 1984 |g 320(2020) vom: 01. Dez., Seite 7-11 |w (DE-627)NLM012621196 |x 1874-1754 |7 nnns |
| 773 | 1 | 8 | |g volume:320 |g year:2020 |g day:01 |g month:12 |g pages:7-11 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.ijcard.2020.07.025 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 320 |j 2020 |b 01 |c 12 |h 7-11 | ||