いわゆる「たこつぼ型心筋障害」10例の臨床橡

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The ampulla cardiomyopathy or Tako-tsubo like left ventricular (LV) dysfunction, is recently characterized as a reversible left ventricular apical wall motion abnormality which mimics acute myocardial infarction without no significant coronary artery occlusion. However, the clinical features and the precise mechanism of this syndrome are still unclear. We reported the clinical characteristics of 10 consecutive patients who were diagnosed as Tako-tsubo like left ventricular dysfunction. The frequency was 0.8% among the patients who underwent coronary angiography (CAG) at the Niigata University Hospital from January, 1999 to December, 2003. The age ranged from 66 to 83 years old (mean age 73.3 years old, and 8 were female). Emotional or physical stress preceded the attack in 8 patients. All patients had ST-T segment elevation and subsequent giant negative T wave in several leads, which mimicked acute coronary syndrome. QT interval was prolonged in 8 patients without lethal arrhythmia. Serum creatine phosphokinase level was normal or slightly elevated. CAG showed no significant stenosis or occulusion in all 5 patients who were investigated in the acute phase, while their electrocardiogram showed ST segment elevation. The LV dysfunction was improved. In the chronic phase coronary spasm was provocated in 3 of 8 patients studied. Myocardial stunning might be involved as the underlying mechanism of this disease but to be studied. In summary so-called Tako-tsubo like left ventricular dysfunction seemed not to be rare and should be considered in the differential diagnosis of acute coronary syndrome. Although clinical course was benign, the etiology is to be studied.
新潟大学の論文
2005-04-10

いわゆる「たこつぼ型心筋障害」10例の臨床橡

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