Association between Tpeak-Tend/QT and major adverse cardiovascular events in patients with Takotsubo syndrome

Abstract

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.

Keywords:

• Takotsubo
• major cardiovascular events
• electrocardiogram
• repolarization
• QT interval
• Tpeak–Tend interval

Acknowledgments

The authors gratefully thank Dr Gloria Chiara for her assistance in the statistical analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).