title: The pathogenesis of reversible T-wave inversions or large upright peaked T-waves: Sympathetic T-waves.
abstract: Reversible electrocardiographic (ECG) repolarization changes including T-wave inversions (TWI), large upright peaked T-waves (LUPTW) and prolongation of the corrected QT interval (P-QTc) have been reported in association with myriads of acute cardiac and non-cardiac diseases. Through the last 70 years, the TWIs have been described under different terms as; cerebral, giant, global, canyon, Wellens or coronary and cardiac memory T waves. During the last 15 years, the reversible TWI and LUPTW in association with P-QTc have been described as characteristic ECG features in takotsubo syndrome (TS), which also may be triggered by the same aforementioned acute cardiac and non-cardiac disease entities. The pathogenesis of these reversible T-wave changes is not clear-cut. In this manuscript, substantial evidences for a causal link between the local cardiac sympathetic disruption and the development of the reversible TWI and LUPTW are presented. As a result, a pathogenetic term for the reversible TWI or LUPTW, which is sympathetic T waves (sympathetic TWI or sympathetic LUPTW), would be the most appropriate term.
authors.affiliation: Karolinska Institute at Karolinska University Hospital, Huddinge, Department of Cardiology, Sweden. Electronic address: shams.younis-hassan@karolinska.se.
authors.forename: Shams
authors.initials: S
authors.lastname: Y-Hassan
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology*; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D004562:Electrocardiography / Q000379:methods*; D006329:Heart Conduction System / Q000002:abnormalities* / Q000503:physiopathology; D006801:Humans; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000503:physiopathology
keywords: Cardiac memory; Cerebral; Coronary; Sympathetic T wave; Takotsubo; Wellens