Inoue Masaru, Shimizu Masami, Ino Hidekazu, Yamaguchi Masato, Terai Hidenobu, Fujino Noboru, Sakata Kenji, Funada Akira, Tatami Ryozo, Ishise Syozo, Kanaya Hounin, Mabuchi Hiroshi
Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Circ J. 2005 Jan;69(1):89-94. doi: 10.1253/circj.69.89.
There has not been a comparison of the electrocardiographic (ECG) finding of ST-segment elevation in the precordial leads in patients with takotsubo cardiomyopathy (TC) and those with anterior acute myocardial infarction (AMI), with regard to the location of the culprit lesion.
The present study evaluated 18 patients with TC, and 85 with anterior AMI who were divided into 3 groups: group A had the culprit lesion proximal to both the first septal branch (S1) and the first diagonal branch (D1), group B had the culprit lesion proximal to either S1 or D1, and group C had the culprit lesion distal to both S1 and D1. In patients with TC, reciprocal ST-segment depression in the inferior leads was observed less frequently than in patients in groups A (p<0.0001) and B (p=0.0002), and abnormal Q waves and ST-segment elevation in the inferior leads were observed more frequently than in group A (p=0.0007, p=0.0057, respectively). The ECG findings in TC did not differ from those in group C.
Electrocardiographic findings may differentiate TC from AMI with a proximal lesion of left anterior descending coronary artery, but not those with distal lesions.
对于应激性心肌病（TC）患者和急性前壁心肌梗死（AMI）患者，尚未就罪犯病变的位置，对比其胸前导联ST段抬高的心电图表现。
本研究评估了18例TC患者和85例急性前壁心肌梗死患者，后者被分为3组：A组罪犯病变位于第一间隔支（S1）和第一对角支（D1）近端；B组罪犯病变位于S1或D1近端；C组罪犯病变位于S1和D1远端。与A组（p<0.0001）和B组（p=0.0002）患者相比，TC患者下壁导联出现ST段压低的频率更低，与A组相比，TC患者下壁导联出现异常Q波和ST段抬高的频率更高（分别为p=0.0007，p=0.0057）。TC患者的心电图表现与C组无差异。
心电图表现可能有助于鉴别TC与左前降支近端病变的AMI，但无法鉴别左前降支远端病变的AMI。
