Any Associations Between the Timing of the Peak QTc Prolongation, Depth of the Admission T‐Wave Inversions, and Extent/Intensity of Myocardial Edema in Patients With Takotsubo Syndrome?

To the Editor: I read with great interest the report by Santoro et al1 about the prognostic significance of the dynamic changes of the QTc intervals in 52 consecutive patients with takotsubo syndrome. The authors found that the 17 patients (group 1), who presented with their maximal QTc interval length at admission, had a higher risk of cardiovascular rehospitalization during a mean of 647 days of follow-up, in comparison with the 35 patients (group 2) who developed maximal QTc interval length after admission. Did the authors find a difference in the depth of the admission T-wave inversions (TWI) (no difference in the prevalence of TWI, 53% vs 49% in group 1 and 2, respectively, P = 0.77), implying that there is a direct association with the depth of the TWI and the QTc? Also, was there any difference in the prevalence of myocardial edema (ME) or its extent/intensity between the 2 groups (even limited data may be useful), underscoring the relationship among TWI, QTc, and ME along the lines reported in the literature2, 3 and discussed by the authors?1