比较心室中部球囊样变型和心尖球囊样变型心肌梗死后心肌病的心电图表现。
Comparison of electrocardiographic findings between the midventricular ballooning form and apical ballooning form of takotsubo cardiomyopathy.
机构信息
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
出版信息
Clin Cardiol. 2011 Sep;34(9):555-9. doi: 10.1002/clc.20934.
BACKGROUND
Several reports have recently described the variant form of takotsubo cardiomyopathy exhibiting midventricular ballooning. The purpose of this study was to assess electrocardiographic (ECG) findings on admission in patients with midventricular ballooning.
HYPOTHESIS
ECG findings are different between the midventricular ballooning form and apical ballooning form of takotsubo cardiomyopathy.
METHODS
We reviewed ECGs on admission in 6 patients with midventricular ballooning and 20 patients with apical ballooning. The sum of ST segment elevation in leads V1 to V3 or in leads V4 to V6 was obtained. The number of leads showing ST segment elevation and/or T wave inversion was also obtained. These ECG findings were compared between the 2 groups.
RESULTS
In midventricular ballooning, ECG changes including ST segment elevation and/or T wave inversion were observed frequently in leads V2 and V3, and were not observed in leads II, III, -aVR, aVF, V5, and V6. On the other hand, in apical ballooning, they were found in all leads. They were most common in leads V4 and V5. The sum of ST segment elevation in leads V1 to V3 was similar (2.6 ± 2.0 mm vs 2.7 ± 2.0 mm, P = not significant), and the sum of ST segment elevation in leads V4 to V6 was significantly lower in midventricular ballooning than apical ballooning (0.4 ± 0.8 mm vs 3.5 ± 3.0 mm, P<0.05). The number of leads showing ST segment elevation and/or T wave inversion was significantly lower in midventricular ballooning than apical ballooning (3.2 ± 1.0 leads vs 6.3 ± 2.2 leads, P<0.01).
CONCLUSIONS
Our data suggested that midventricular ballooning may show limited ECG changes despite broad wall motion abnormality.
背景
最近有几份报告描述了表现为中段气球样变的心肌梗死后心尖球囊样变的变异型。本研究的目的是评估中段气球样变患者入院时的心电图（ECG）表现。
假说
中段气球样变和心尖气球样变的心电图表现不同。
方法
我们回顾了 6 例中段气球样变和 20 例心尖气球样变患者的入院心电图。获得 V1 到 V3 导联或 V4 到 V6 导联的 ST 段抬高总和。还获得了显示 ST 段抬高和/或 T 波倒置的导联数。比较了两组的心电图表现。
结果
在中段气球样变中，心电图改变包括 ST 段抬高和/或 T 波倒置，常见于 V2 和 V3 导联，而 II、III、-aVR、aVF、V5 和 V6 导联未见改变。另一方面，在心尖气球样变中，所有导联均可见改变，以 V4 和 V5 导联最常见。V1 到 V3 导联的 ST 段抬高总和相似（2.6 ± 2.0 mm 比 2.7 ± 2.0 mm，P = 无显著性），而 V4 到 V6 导联的 ST 段抬高总和在心尖气球样变中明显高于中段气球样变（0.4 ± 0.8 mm 比 3.5 ± 3.0 mm，P<0.05）。显示 ST 段抬高和/或 T 波倒置的导联数在心尖气球样变中明显高于中段气球样变（3.2 ± 1.0 导联比 6.3 ± 2.2 导联，P<0.01）。
结论
尽管中段气球样变的壁运动异常广泛，但我们的数据表明其心电图改变可能有限。
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