{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:32:42Z","timestamp":1740137562944,"version":"3.37.3"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,11,8]],"date-time":"2018-11-08T00:00:00Z","timestamp":1541635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>PR segment deviation (PRD: defined as PR elevation in aVR and PR depression in lead II\/III) on electrocardiography is frequently observed in patients with acute pericarditis; however, there have been few studies that explore the occurrence of PRD in patients with Takotsubo syndrome (TTS). The clinical significance of PRD in TTS is not clearly elucidated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; results<\/jats:title><jats:p>A total of 52 consecutive patients with TTS in sinus rhythm (73.9 \u00b1 13.8 years, nine males) were enrolled in the study. The major cardiac events were defined as sustained ventricular tachycardia or ventricular fibrillation, Killip class 4 heart failure, and cardiac death within 30 days. PRD in the hyperacute phase (within 48 h from the onset of TTS) was observed in 15 patients (29%), and all PRDs disappeared or diminished at 1 week later. The PRD (+) group had a higher value of C\u2010reactive protein level (median: 1.80\u00a0mg\/dL [0.31\u20103.26] vs 0.20\u00a0mg\/dL [0.06\u20100.81], <jats:italic>P<\/jats:italic>\u00a0\u00a0=\u00a0\u00a00.013) and creatine kinase\u2010muscle\/brain isoenzyme (median: 60\u00a0IU\/L [28\u201075] vs 17\u00a0IU\/L [13\u201026], <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001) and a lower level of left ventricular ejection fraction (42.7 \u00b1 7.2% vs 48.8 \u00b1 9.4%, <jats:italic>P<\/jats:italic>\u00a0\u00a0=\u00a0\u00a00.041) than the PRD (\u2212) group. Multivariate analysis showed that PRD was a significant and independent predictor for major cardiac events (odds ratio\u00a0\u00a0=\u00a0\u00a021.0, 95% confidence interval\u00a0\u00a0=\u00a0\u00a01.18\u2010273).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TTS patients with PRD in the hyperacute phase showed a high incidence of major cardiac events. Therefore, PRD may help to identify TTS patients at high risk for cardiac event.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.13530","type":"journal-article","created":{"date-parts":[[2018,10,23]],"date-time":"2018-10-23T10:44:06Z","timestamp":1540291446000},"page":"1652-1659","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["PR deviation as a risk marker for cardiac events in patients with Takotsubo syndrome"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1237-7633","authenticated-orcid":false,"given":"Masato","family":"Shimizu","sequence":"first","affiliation":[{"name":"Department of Cardiology Yokohama Minami Kyosai Hospital  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Cardiology Yokohama Minami Kyosai Hospital  Yokohama 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