Critical Convex-Type ST Elevation Correlate With Ventricular Tachyarrhythmia in Takotsubo Cardiomyopathy

IF 2.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Clinical Cardiology Pub Date : 2024-12-09 DOI:10.1002/clc.70056
Jen-Te Hsu, Ju-Feng Hsiao, See-Khong Chin, Yu-Cheng Hsu, Meng-Huan Lei
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Abstract

Background

Ventricular tachyarrhythmia (VT) occasionally occurred in patients with Takotsubo cardiomyopathy (TC). Two convex-type ST elevations were significantly related to VT in coronary artery disease.

Methods

This study assessed the correlation between VT and critical ECG patterns, as well other independent predictive factors of in-hospital outcome. Fifty-five consecutive patients fulfilled the diagnostic criteria of Takotsubo Italian Network (TIN) were retrospectively enrolled. The patients were classified into two groups according to their critical ECG patterns and VT occurrence. In-hospital outcomes and influencing factors were analyzed.

Results

The incidence of VT was higher in the critical ECG group than in the Noncritical ECG group (43.8% vs. 2.6%, p < 0.001). In-hospital death was more common in the critical ECG group than in the Noncritical ECG group (25.0% vs. 5.1%, p = 0.032). The composite end-point (combined VT and in-hospital death) revealed significant differences between these two groups (50.0% vs 7.7%, p < 0.001). Multi-variate analysis proved critical ECG type as one independent risk factor of VT (odds ratio [OR] = 61.8, p = 0.009) and the composite end-point (OR = 12.4, p = 0.007). The prolong QRS width ( ≥ 105 ms) was another independent factor for predicting VT (OR = 1.06, p = 0.022) and composite end-point (OR = 1.05, p = 0.017).

Conclusions

Critical ECG types including tombstoning ST elevation and lambda-wave ST elevation have strong impact on short-term outcomes. Additionally, conduction disturbance with prolong QRS ≥ 105 ms also has independent predicting role for poor prognosis.

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Takotsubo型心肌病的临界凸型ST段抬高与室性心动过速相关。
背景:Takotsubo心肌病(TC)患者偶尔会发生室性心动过速(VT)。在冠状动脉疾病中,两次凸型ST段升高与VT显著相关。方法:本研究评估室速与关键心电图模式的相关性,以及其他独立的院内预后预测因素。55例符合Takotsubo意大利网络(TIN)诊断标准的连续患者被回顾性纳入。根据危重心电图型和室速发生情况将患者分为两组。分析住院结局及影响因素。结果:危重心电图组VT发生率高于非危重心电图组(43.8% vs. 2.6%)。结论:墓碑性ST段抬高和蓝波性ST段抬高等危重心电图类型对短期预后有较大影响。此外,QRS≥105 ms的传导干扰对预后不良也有独立的预测作用。
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来源期刊
Clinical Cardiology
Clinical Cardiology 医学-心血管系统
CiteScore
5.10
自引率
3.70%
发文量
189
审稿时长
4-8 weeks
期刊介绍: Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.
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