title: Serial electrocardiographic findings in women with Takotsubo cardiomyopathy.
abstract: 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.
authors.affiliation: Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. mwataru@med.niigata-u.ac.jp
authors.forename: Wataru
authors.initials: W
authors.lastname: Mitsuma
authors.forename: Makoto
authors.initials: M
authors.lastname: Kodama
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.forename: Komei
authors.initials: K
authors.lastname: Tanaka
authors.forename: Takao
authors.initials: T
authors.lastname: Yanagawa
authors.forename: Noboru
authors.initials: N
authors.lastname: Ikarashi
authors.forename: Kanako
authors.initials: K
authors.lastname: Sugiura
authors.forename: Shinpei
authors.initials: S
authors.lastname: Kimura
authors.forename: Nobue
authors.initials: N
authors.lastname: Yagihara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kashimura
authors.forename: Koichi
authors.initials: K
authors.lastname: Fuse
authors.forename: Satoru
authors.initials: S
authors.lastname: Hirono
authors.forename: Yuji
authors.initials: Y
authors.lastname: Okura
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: 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
chemical_list: D003402:Creatine Kinase