Document Detail

Myocardial Oedema Underlies Dynamic T-Wave Inversion (Wellens'ECG Pattern) in Patients with Reversible Left Ventricular Dysfunction.
MedLine Citation:
PMID:  21699846     Owner:  NLM     Status:  Publisher    
BACKGROUND: The Wellens' ECG pattern of dynamic T-wave inversion in the anterior leads is observed in clinical conditions characterized by reversible left ventricular (LV) dysfunction ("stunned myocardium"), either ischemic or non-ischemic. The pathophysiologic basis of this ECG pattern remains to be elucidated. OBJECTIVE: The purpose of this study was to report the contrast-enhanced cardiac magnetic resonance (CE-CMR) findings in four cases of Wellens' ECG pattern associated with transient LV dysfunction from a variety of clinical conditions such as myocardial bridge, coronary artery dissection, cholecystitis and Tako-Tsubo syndrome. METHODS: All patients underwent CE-CMR at the time of acute clinical manifestations and after 6-8 weeks of follow-up to assess the presence and dynamics of LV myocardial changes. RESULTS: In all patients, the Wellens' ECG abnormalities were associated with increased signal intensity of the LV myocardium on T2-weighted sequences suggesting myocardial oedema, in the absence of late-enhancement on post-contrast sequences. Repolarization abnormalities and myocardial oedema had a parallel time course with persistence beyond recovery of mechanical abnormalities. T-wave inversion was associated with transient prolongation of the QTc interval in all cases. CONCLUSIONS: The study results suggest that myocardial oedema rather than systolic dysfunction underlies the Wellen's ECG pattern, regardless of the causative mechanism.
Federico Migliore; Alessandro Zorzi; Martina Perazzolo Marra; Cristina Basso; Francesco Corbetti; Manuel De Lazzari; Giuseppe Tarantini; Paolo Buja; Carmelo Lacognata; Gaetano Thiene; Domenico Corrado; Sabino Iliceto
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-10
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-6-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Department of Cardiac, Thoracic and Vascular Sciences, University of Padova.
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