Department of Neurology, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68135, Mannheim, Germany.
First Department of Medicine - Cardiology, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany.
J Neurol. 2019 Dec;266(12):3048-3057. doi: 10.1007/s00415-019-09529-0. Epub 2019 Sep 10.
To analyse whether patients with transient global amnesia (TGA) have concomitant cardiac injury by assessing clinical symptoms, as well as blood and cardiologic test results.
In this retrospective observational study, we analysed 202 consecutive patients presenting with isolated TGA and treated at our institution between March 2010 and December 2018. We examined the incidence of high-sensitivity cardiac troponin I (hs-cTNI) level elevation, electrocardiogram (ECG) findings, and data on clinical management.
Among the TGA patients, 17 (8.4%) exhibited elevated levels of hs-cTNI. Although none of the patients had ST elevation, 12 (6.7%) showed QTc prolongation and 11 (6.1%) an inverted T wave on ECG. No typical clinical symptoms suggestive of myocardial infarction were present in any of the cases, however, 17 (8.4%) patients complained of mild somatic symptoms. Patients with hs-cTNI level elevation had a significantly greater likelihood of a history of coronary heart disease (p = 0.03) and a significantly shorter TGA duration at presentation (p < 0.01). Of the 17 patients with hs-cTNI elevation, Takotsubo syndrome was diagnosed in 2, while in the remaining 15 hs-cTNI level elevation remained unresolved. A literature review indicated the female predominance for the occurrence of cardiac involvement in TGA.
Although the in-hospital outcomes appear favourable in all cases reported thus far, we believe that all patients with TGA should be carefully evaluated for potential underlying cardiac involvement and comorbidity. Further research on cardiac vulnerability in TGA should attempt to develop a diagnostic algorithm and assess the potential causes of cardiac injury in TGA.
通过评估临床症状以及血液和心脏检查结果，分析短暂性全面遗忘症（TGA）患者是否伴有心脏损伤。
在这项回顾性观察研究中，我们分析了 202 例在我院就诊的单纯 TGA 患者，这些患者于 2010 年 3 月至 2018 年 12 月期间接受了治疗。我们检查了高敏心肌肌钙蛋白 I（hs-cTNI）水平升高、心电图（ECG）发现以及临床管理数据的发生率。
在 TGA 患者中，有 17 例（8.4%）hs-cTNI 水平升高。尽管没有患者出现 ST 段抬高，但 12 例（6.7%）表现为 QTc 延长，11 例（6.1%）出现 T 波倒置。然而，在任何病例中都没有出现提示心肌梗死的典型临床症状，但有 17 例（8.4%）患者诉有轻微的躯体症状。hs-cTNI 水平升高的患者更有可能有冠心病病史（p=0.03），且就诊时 TGA 持续时间更短（p<0.01）。在 17 例 hs-cTNI 升高的患者中，2 例诊断为 Takotsubo 综合征，而其余 15 例的 hs-cTNI 水平升高仍未解决。文献复习表明，TGA 中心脏受累更常见于女性。
尽管迄今为止报告的所有病例的住院结局似乎都良好，但我们认为所有 TGA 患者都应仔细评估潜在的心脏受累和合并症。进一步研究 TGA 中心脏的脆弱性应尝试制定诊断算法，并评估 TGA 中心肌损伤的潜在原因。
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