ArticleAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2018
"Lambda-wave" ST-elevation is associated with severe prognosis in stress (takotsubo) cardiomyopathy.
Article in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 26 citations in OpenAlex.
- The 'shark fin sign' - a morbid and rare electrocardiographic presentation in takotsubo cardiomyopathy.European heart journal. Case reports · 2026Article
- Inferior-Lead Lambda (λ) Wave Revealing Critical Right Coronary Artery Stenosis: A Case Report.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026Article
- Case Report: Dynamic J-point elevation as a novel precursor to torsade de pointes: electrocardiographic markers for proactive management.Frontiers in cardiovascular medicine · 2025Article
- Critical Convex-Type ST Elevation Correlate With Ventricular Tachyarrhythmia in Takotsubo Cardiomyopathy.Clinical cardiology · 2024Article
- A case of Takotsubo syndrome with polymorphic ventricular tachycardia and shark fin electrocardiogram developed during hospitalization for occlusive arterial disease of the lower extremities.Journal of cardiology cases · 2024Article
- Shark fin sign: A rare EKG finding in a patient with Takotsubo cardiomyopathy from influenza A infection.Clinical case reports · 2024Article
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- Spiked Helmet Sign: An Uncommon Electrocardiographic Marker.Reviews in cardiovascular medicine · 2023Review
- Shark Fin Occlusive Myocardial Infarction ECG Pattern Post-cardiac Arrest Misinterpreted As Ventricular Tachycardia.Cureus · 2023Article
- ST-segment elevation in a critically ill patient: Greek letters, war helmets, and broken hearts.Journal of arrhythmia · 2021Article
- A 'shark'-masked electrocardiogram: case report of a Tako-Tsubo syndrome.European heart journal. Case reports · 2021Article
- Triangular QRS-ST-T Waveform Electrocardiographic Pattern in Acute Myopericarditis: A Case Report from a Limited-Resources Hospital.The American journal of case reports · 2020Article
- Early Recognition of Electrocardiographic Lambda-Wave ST Elevation during Propofol Infusion Prevents Ventricular Tachyarrhythmia and Cardiac Arrest.Acta Cardiologica Sinica · 2020Article
- The electrocardiographic 'triangular QRS-ST-T waveform' pattern: a marker of severe haemodynamic compromise in Takotsubo syndrome-a case report.European heart journal. Case reports · 2020Article
- "Lambda-wave" ST-elevation is associated with severe prognosis in stress (takotsubo) cardiomyopathy.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2018Article
- The non-acute coronary syndrome related ST-elevation patterns (NASTEP) conundrum: War helmets, Greek letters, and… "shark fins".Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2018Article
- Other correlates of "lambda wave" in patients with takotsubo syndrome?Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2018Article
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Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPersistent ST-segment elevation in acute coronary syndrome is associated with both short and long-term complications. By contrast, there is limited information about ST-elevation and its evolution during takotsubo (stress) cardiomyopathy (TTC).
aimTo evaluate whether persistent downsloping ST-elevation in the early stages of TTC might correlate with short and long-term clinical events.
methodsOne-hundred fifty-eight consecutive subjects with TTC were prospectively enrolled and assessed by electrocardiogram. Patients were classified in two groups according to the presence of downsloping ST-elevation ≥5 mm lasting at least 24 hr ("lambda-wave" ST-elevation group vs. without downsloping ST-elevation) in at least one/two contiguous leads.
resultsFive (3.2%) patients, all female with a mean left ventricular ejection fraction 32 ± 5%, were included in the lambda-wave ST-elevation group. These patients were characterized by a higher prevalence of physical stressor (100% vs. 49%, p = 0.04) and higher admission and peak levels of troponin-I levels during hospitalization. Peak of ST-elevation in the lambda-wave ST-elevation group was reached 6 hr after admission and gradually decreased after 24 hr. In-hospital complications were observed in all the patients presenting lambda ST-elevation (100% vs. 23%, p = 0.03, OR: 29.1, p = 0.04); one patient presented endoventricular thrombosis and two died of cardiogenic shock. At long-term follow-up (mean 443 days), adverse events were observed in 80% of patients with lambda-wave ST-elevation (RR of adverse events at follow-up 32, p < 0.01).
conclusionPersistent downsloping lambda-wave ST-elevation during the acute phase of stress cardiomyopathy may be associated with a higher risk of adverse events at short and long-term follow-up.
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