“Lambda‐wave” ST‐elevation is associated with severe prognosis in stress (takotsubo) cardiomyopathy

• DOI: 10.1111/anec.12581
• Publication Date: 2018-07-09T08:35:26Z
• Authors: Nicola Tarantino; Francesco Santoro; Francesca Guastaf...; Luigi F. M. Di Ma...; Maria Scarcia; Riccardo Ieva; Antonio Ruggiero; Andrea Cuculo; Enrica Mariano; Matteo Di Biase; Natale Daniele Br...
• Keywords: ST elevation; Troponin T

Abstract Background Persistent ST ‐segment elevation in acute coronary syndrome is associated with both short and long‐term complications. By contrast, there limited information about ‐elevation its evolution during takotsubo (stress) cardiomyopathy ( TTC ). Aim To evaluate whether persistent downsloping the early stages of might correlate clinical events. Methods One‐hundred fifty‐eight consecutive subjects were prospectively enrolled assessed by electrocardiogram. Patients classified two groups according to presence ≥5 mm lasting at least 24 hr (“lambda‐wave” group vs. without ‐elevation) one/two contiguous leads. Results Five (3.2%) patients, all female a mean left ventricular ejection fraction 32 ± 5%, included lambda‐wave group. These patients characterized higher prevalence physical stressor (100% 49%, p = 0.04) admission peak levels troponin‐I hospitalization. Peak was reached 6 after gradually decreased hr. In‐hospital complications observed presenting lambda 23%, 0.03, OR : 29.1, 0.04); one patient presented endoventricular thrombosis died cardiogenic shock. At follow‐up (mean 443 days), adverse events 80% RR 32, < 0.01). Conclusion phase stress may be risk follow‐up.