title: Differences in negative T waves between takotsubo cardiomyopathy and reperfused anterior acute myocardial infarction.
abstract: BACKGROUND
  In both takotsubo cardiomyopathy (TC) and reperfused anterior acute myocardial infarction (AMI), negative T waves commonly appear on the ECG in the subacute phase. This study aimed to clarify the ECG differences between these diseases.
  
  
  RESULTS
  We compared the ECGs with the greatest amplitude of negative T wave from 34 patients with TC and 237 patients with a first reperfused anterior AMI who were admitted within 6 h of symptom onset and who had no abnormal Q-waves on discharge ECG. Time from symptom onset to recording the ECG did not differ between TC and anterior AMI (2.4 ± 1.5 vs. 2.1 ± 2.0 days, P = 0.48). TC was associated with a greater maximal amplitude of negative T wave (1.00 ± 0.44 vs. 0.79 ± 0.46 mV, P = 0.044), and a greater number of leads with negative T waves (9.5 ± 1.0 vs. 6.0 ± 2.1, P<0.001). Negative T waves were consistently observed in leads -aV(R) and V(4-6), whereas negative T waves were rare in lead V(1) in TC. Negative T waves in lead -aV(R) (ie, positive T waves in lead aV(R)) and no negative T waves in lead V(1) identified TC with 94% sensitivity and 95% specificity, representing the highest diagnostic accuracy.
  
  
  CONCLUSIONS
  During the subacute phase, deeper negative T waves were more frequently and broadly distributed, particularly around leads facing the apical region, in TC than in reperfused anterior AMI.
authors: Division of Cardiology, Yokohama City University Medical Center, Japan. masami-kosuge@pop06.odn.ne.jp
authors: Masami
authors: M
authors: Kosuge
authors: Toshiaki
authors: T
authors: Ebina
authors: Kiyoshi
authors: K
authors: Hibi
authors: Noriaki
authors: N
authors: Iwahashi
authors: Kengo
authors: K
authors: Tsukahara
authors: Mitsuaki
authors: M
authors: Endo
authors: Nobuhiko
authors: N
authors: Maejima
authors: Zenko
authors: Z
authors: Nagashima
authors: Hiroyuki
authors: H
authors: Suzuki
authors: Satoshi
authors: S
authors: Morita
authors: Satoshi
authors: S
authors: Umemura
authors: Kazuo
authors: K
authors: Kimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D056988:Anterior Wall Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion; D011237:Predictive Value of Tests; D013318:Stroke Volume / Q000502:physiology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000503:physiopathology*