Why the study?
Conflicting data exist on the relationship between ECG parameters and complications in Takotsubo syndrome, prompting an investigation into markers of ventricular repolarization and in-hospital MACE.
Does the Tpe/QT ratio on admission ECG predict major adverse cardiovascular events during hospitalization in patients with Takotsubo syndrome?
Does the Tpe/QT ratio on admission ECG predict major adverse cardiovascular events during hospitalization in patients with Takotsubo syndrome?
The Tpe/QT ratio on admission ECG, especially when combined with low ejection fraction, may serve as a useful prognostic marker for in-hospital MACE in patients with Takotsubo syndrome.
May identify higher in-hospital MACE risk in Takotsubo when combined with low EF; hypothesis-generating and requires prospective validation.
BACKGROUND: Conflicting results have been described in the scientific literature regarding the relationship between electrocardiographic parameters and complications in patients with Takotsubo syndrome (TTS). Aim of the present study was to investigate whether there is an association between markers of ventricular repolarization and major adverse cardiovascular events (MACE) during hospitalisation. METHODS: A retrospective chart review was conducted on a sample of patients with diagnosis of TTS, based on the fulfilment of the revised Mayo Clinic criteria. MACE included acute heart failure, cardiogenic shock, sustained ventricular tachycardia, ventricular fibrillation, and death. The following parameters, assessed on the admission electrocardiogram, were analysed: ST-segment elevation, ST-segment depression, T wave inversion, presence of Q waves, QT interval, QT interval corrected for heart rate, QT-dispersion, Tpeak-Tend (Tpe) interval, Tpe dispersion, Tpe/QT ratio, and QTpeak/QT ratio. RESULTS: Patients with MACE, compared to patients without MACE, showed more commonly anterior ST-segment elevation and had significantly higher values of Tpe/QT ratio. Low ejection fraction and Tpe/QT ratio > 0.27 identified a sub-population of patients more likely to have MACE during hospitalisation. CONCLUSIONS: Tpe/QT ratio represents a useful electrocardiographic parameter in the acute phase of TTS.
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Braschi et al. (2020) studied this question.
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