Serial electrocardiographic findings in women with Takotsubo cardiomyopathy.
This study aimed to clarify detailed and serial electrocardiographic findings in patients with Takotsubo cardiomyopathy from onset to recovery. Nine consecutive women aged 65 to 84 years (mean 74) with Takotsubo cardiomyopathy were investigated. Standard 12-lead electrocardiograms were recorded during hospitalization and ST-segment elevation and T-wave inversion were manually measured daily in each patient. All 9 patients had 4 phases found electrocardiographically. Phase 1 was characterized by ST-segment elevation immediately after onset. Subsequently, T-wave inversion was observed from days 1 to 3 (phase 2), then inverted T waves improved transiently from days 2 to 6 (phase 3). After this phase, giant inverted T waves with QT prolongation appeared and persisted > or =2 months until recovery (phase 4). Serum creatine kinase levels were increased only at onset. Left ventricular wall motion abnormalities evaluated using echocardiography improved gradually after phase 3 in all patients. Second T-wave inversions (phase 4) were significantly deeper than those of the first one (phase 2; p <0.05). In conclusion, 4 electrocardiographic phases in patients with Takotsubo cardiomyopathy were shown. This observation may be helpful to understand the pathophysiologic process of Takotsubo cardiomyopathy.
Mitsuma
Wataru
W
Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. mwataru@med.niigata-u.ac.jp
Kodama
Makoto
M
Ito
Masahiro
M
Tanaka
Komei
K
Yanagawa
Takao
T
Ikarashi
Noboru
N
Sugiura
Kanako
K
Kimura
Shinpei
S
Yagihara
Nobue
N
Kashimura
Takeshi
T
Fuse
Koichi
K
Hirono
Satoru
S
Okura
Yuji
Y
Aizawa
Yoshifusa
Y
D000368:Aged; D000369:Aged, 80 and over; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology*; D003402:Creatine Kinase / Q000097:blood; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System; D006801:Humans; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology
D003402:Creatine Kinase