前壁ST段抬高型心肌梗死与应激性心肌病的心电图动态变化
Temporal electrocardiographic changes in anterior ST elevation myocardial infarction versus the Takotsubo syndrome.
作者信息
Zeijlon Rickard, Jha Sandeep, Le Vina, Chamat Jasmina, Shekka Espinosa Aaron, Poller Angela, Thorleifsson Sigurdur, Bobbio Emanuele, Mellberg Tomas, Pirazzi Carlo, Gudmundsson Thorsteinn, Martinsson Andreas, Angerås Oskar, Råmunddal Truls, Omerovic Elmir, Redfors Björn
机构信息
Department of Cardiology, Sahlgrenska University Hospital/S, Gothenburg, Sweden.
Department of Internal Medicine, Sahlgrenska University Hospital/S, Gothenburg, Sweden.
出版信息
Int J Cardiol Heart Vasc. 2023 Feb 18;45:101187. doi: 10.1016/j.ijcha.2023.101187. eCollection 2023 Apr.
BACKGROUND
Electrocardiography (ECG) on admission is similar in ST elevation myocardial infarction (STEMI) and Takotsubo syndrome (TTS). ECG on admission has been extensively investigated and compared between STEMI and TTS, however, only a few studies have compared temporal ECG. Our aim was to compare ECG in anterior STEMI versus female TTS from admission to day 30.
METHODS
Adult patients with anterior STEMI or TTS treated at Sahlgrenska University Hospital (Gothenburg, Sweden) from December 2019 to June 2022 were prospectively enrolled. Baseline characteristics, clinical variables and ECGs from admission to day 30 were analyzed. Using a mixed effects model, we compared temporal ECG between female patients with anterior STEMI or TTS, as well as between female and male patients with anterior STEMI.
RESULTS
A total of 101 anterior STEMI patients (31 female, 70 male) and 34 TTS patients (29 female, 5 male) were included. The temporal pattern of T wave inversion was similar between female anterior STEMI and female TTS, as well as between female and male anterior STEMI. ST elevation was more common, whereas QT prolongation was less common, in anterior STEMI compared with TTS. Q wave pathology was more similar between female anterior STEMI and female TTS than between female and male anterior STEMI.
CONCLUSIONS
The pattern of T wave inversion and Q wave pathology from admission to day 30 was similar in female patients with anterior STEMI and female patients with TTS. Temporal ECG in female patients with TTS may be interpreted as following a "transient ischemic" pattern.
背景
ST段抬高型心肌梗死（STEMI）和Takotsubo综合征（TTS）患者入院时的心电图表现相似。目前已经对STEMI和TTS患者入院时的心电图进行了广泛研究和比较，然而，仅有少数研究比较了动态心电图。我们的目的是比较前壁STEMI与女性TTS患者从入院至第30天的心电图情况。
方法
前瞻性纳入2019年12月至2022年6月在瑞典哥德堡萨尔格伦斯卡大学医院接受治疗的前壁STEMI或TTS成年患者。分析患者的基线特征、临床变量以及从入院至第30天的心电图。我们使用混合效应模型比较前壁STEMI女性患者与TTS女性患者之间以及前壁STEMI女性与男性患者之间的动态心电图。
结果
共纳入101例前壁STEMI患者（女性31例，男性70例）和34例TTS患者（女性29例，男性5例）。前壁STEMI女性患者与TTS女性患者之间以及前壁STEMI女性与男性患者之间T波倒置的动态模式相似。与TTS相比，ST段抬高在前壁STEMI中更常见，而QT间期延长则较少见。前壁STEMI女性患者与TTS女性患者之间的Q波病变比前壁STEMI女性与男性患者之间更相似。
结论
前壁STEMI女性患者与TTS女性患者从入院至第30天的T波倒置和Q波病变模式相似。TTS女性患者的动态心电图可能被解释为遵循“短暂性缺血”模式。
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