To the Editor— Electrocardiogram correlates of myocardial edema in patients with Takotsubo syndrome

Abstract

Marra et al1 reported on the correlation of the regional myocardial edema (ME) and the electrocardiogram (ECG) T-wave inversions (TWIs) in 20 consecutive patients with Takotsubo syndrome (TTS), building on their previous work on the same topic.2 The authors refer to the observed precordial TWIs and prolonged corrected QT (QTc) intervals as the “Wellens’ ECG pattern,”1,2 quoting the article of de Zwaan et al,3 although that work does not mention prolonged, or any kinds, of QT intervals at all. A significant linear correlation was detected between the TWIs and the QTc intervals, with the cardiac magnetic resonance imaging (cMRI)-derived apicobasal ratio of T2-weighted signal intensity for ME, at the time of the initial ECG/cMRI assessment, but no correlation was detected in the TWI with wall contraction abnormalities (WCAs) or mild late gadolinium enhancement, indicating that repolarization changes are due to ME.