Tako-Tsubo-like cardiomyopathy: specific ECG findings, characterization and clinical findings in a European single center.

A newly discovered heart syndrome mimicking acute coronary syndrome has been termed 'Tako-Tsubo cardiomyopathy' (TTC). Differentiation from acute myocardial infarction using the ECG is an important issue in clinical practice. We retrospectively analyzed patients admitted for cardiac catheterization between September 2003 and September 2006. From 26,593 cardiac catheterization procedures, we identified 21 patients with suggested TTC (0.08%). Trigger mechanisms were present in 38.1%; all patients had elevated troponin levels (mean 3.9 ng/ml). Median age was 68.4 years; 90.5% were female. Hypertension was seen in 85.7% and atrial fibrillation in 19.1%. Specific ECG findings related to a TTC are: a mild elevation of the ST segment arising from the S curve of the QRS complex, where the maximum ST segment elevation at the basis of the T wave is <1.5 mm, T-wave inversion, absence of ST segment depression and a summated amplitude of the S curve in V1 plus R in V6 <1.5 mV. An intraventricular gradient was seen in 9.5%; coronary atherosclerosis was detected in 57.1%. Follow-Up Data: Mean follow-up was 13.2 months. 47.6% were free from angina or dyspnea, most of the patients received beta-blockers/ACE inhibitors (76.2%). One patient had a sudden cardiac death (4.8%), 1 patient became an implantable cardioverter-defibrillator primarily due to resuscitation. TTC is a rare syndrome mimicking acute coronary syndrome that shows a specific ECG pattern and does not appear to be an unambiguously benign disease.

von Korn H ，Yu J ，Lotze U ，Ohlow MA ，Huegl B ，Schulte W ，Haberl K ，Wagner A ，Gruene S ，Lauer B ... -  《-》

Electrocardiogram mimics of acute ST-segment elevation myocardial infarction: insights from cardiac magnetic resonance imaging in patients with tako-tsubo (stress) cardiomyopathy.

Sharkey SW 《-》

Spectrum and significance of electrocardiographic patterns, troponin levels, and thrombolysis in myocardial infarction frame count in patients with stress (tako-tsubo) cardiomyopathy and comparison to those in patients with ST-elevation anterior wall myoc

Sharkey SW ，Lesser JR ，Menon M ，Parpart M ，Maron MS ，Maron BJ ... -  《-》

Assessment of the value of pre-catheterization in diagnosis of st-segment elevation myocardial infarction and tako-tsubo cardiomyopathy.

Agladze R ，Pagava Z ，Mamatsashvili M ，Sharashidze N ，Jinjolia N ... -  《-》

[Clinical spectrum of tako-tsubo cardiomyopathy in Germany: results of the tako-tsubo registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)].

Tako-tsubo cardiomyopathy (TTC) was first described in 1990 in Japan. A TTC registry was initiated by the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK) in order to evaluate the clinical spectrum and the management of patients with this syndrome in Germany. Patients from 37 hospitals were included in the registry if they fulfilled the following criteria: 1. acute chest symptoms or syncope, 2. new ischemic ECG changes with ST-segment elevation ± T-wave inversion, 3. reversible left ventricular regional wall motion abnormality not corresponding to a single coronary artery territory, 4. absence of significant coronary artery stenoses. 296 of the 324 patients (age 68 ±  12) were women (91 %) and 28 men (9 %). Leading symptoms were angina pectoris (72 %), dyspnoea (16 %), syncope (3 %) or resuscitation/cardiogenic shock (2 %). An antecedent trigger was found in 77  %. Time from symptom onset to hospital admission was 7,6  ±  6,9 hours. An acute coronary syndrome (ACS) was clinically suspected in 87 %. The ECG showed ST-segment elevation in 85 %. Cardiac troponin was elevated in more than 90 % of patients. Left ventricular ejection fraction by angiography was reduced to 49 ± 14 %. Initial medical treatment corresponded to the working diagnosis of an ACS. Catecholamines or an intraaortic balloon pump were necessary in 5 % and 1 %, respectively. Seven patients (2.2 %) died in hospital. TTC afflicts mainly women and presents clinically as an ACS in 87 %. Hospital mortality is low with symptomatic therapy.

Schneider B ，Athanasiadis A ，Schwab J ，Pistner W ，von Scheidt W ，Gottwald U ，Schamberger R ，Schoeller R ，Bublak A ，Toepel W ，Winter KD ，Sechtem U ... -  《-》