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Clinical Research in Cardiology

, Volume 108, Issue 1, pp 68–73 | Cite as

Novel ECG-based scoring tool for prediction of takotsubo syndrome

  • Natig GassanovEmail author
  • Minh Tam Le
  • Evren Caglayan
  • Martin Hellmich
  • Erland Erdmann
  • Fikret Er
Original Paper

Abstract

Background

Takotsubo syndrome (TS) usually involves ECG changes mimicking acute myocardial infarction (AMI). The differentiation of both disorders is crucial for selection of appropriate treatment. The aim of this study was to assess ECG parameters in patients with TS and AMI, and try to establish a scoring tool for TS prediction.

Methods

The study consisted of two study parts: evaluation and validation cohorts. Overall, the study included 82 patients with TS and 141 subjects with AMI. In addition to the major demographic characteristics and comorbidities, the following ECG parameters were analyzed: heart rate, QRS duration, QTc, QRS amplitudes in frontal and precordial leads, frequencies for ST-segment elevation, combined sign of positive ST-segment elevation in -aVR and absent in V1, negative T-wave in lead I and positive in III, inverted or biphasic T-waves in V2–V5, T-wave inversions in frontal and precordial leads. All significant variables were identified in univariate regression analysis and further included for multivariate logistic regression analysis predicting TS.

Results

TS was frequently diagnosed in women and in elderly patients. Presence of ST-segment elevation, inverted/biphasic T-waves in V2–V5, QRS amplitudes in frontal and precordial leads were significantly different in evaluation group. By multivariate regression analysis sex, QRS amplitudes in frontal, inverted or biphasic T-waves in septal leads and QTc were identified as powerful variables to calculate TS probability. The diagnostic accuracy of the developed 6-points-TS-score was then evaluated in the validation group. Thus, no subject with a TS-score of ≥ 5 had AMI (specificity 99%, sensitivity > 92%).

Conclusion

The developed ECG-based TS-score model may be a useful complimentary tool for TS prediction in acute clinical setting.

Keywords

Takotsubo cardiomyopathy Acute myocardial infarction Electrocardiography 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Internal Medicine IKlinikum GüterslohGüterslohGermany
  2. 2.Department of Internal Medicine IIIUniversity of RostockRostockGermany
  3. 3.Institute of Medical Statistics, Epidemiology and Computer ScienceUniversity of CologneCologneGermany
  4. 4.Department of Internal Medicine IIIUniversity of CologneCologneGermany

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