Early T wave inversion after thrombolytic therapy predicts better coronary perfusion: Clinical and angiographic study

Matetzky, Shlomi; Barabash, Gabriel I.; Shahar, Amir; Rabinowitz, Babeth; Rath, Shmuel; Zahav, Yedael Har; Agranat, Oren; Kaplinsky, Elieser; Hod, Hanoch

doi:10.1016/0735-1097(94)90291-7

Cited by 55 publications

(30 citation statements)

References 34 publications

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“…[3][4][5] However, ST segments and T waves attain a stable pattern only 7-10 days after the acute phase. 6) Therefore, the predischarge ECG may be a more accurate predictor of left ventricular function.…”

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confidence: 99%

Predischarge ST Segment and T Wave Patterns in Predicting Left Ventricular Function and Myocardial Viability in Q Wave Anterior Myocardial Infarction Patients

2005

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SUMMARYThe aim of this study was to investigate the correlation between ECG changes prior to discharge and findings of early low dose dobutamine stress echocardiography (LDSE) performed in 6 ± 2 days, in patients experiencing their first acute anterior MI.A total of 62 patients admitted with their first acute anterior MI were divided into three groups according to the findings of electrocardiograms performed on the 7-10th days: group A, isoelectric ST and negative or positive T wave; group B, ST elevation (> 0.1 mV) and negative T wave; and group C, ST elevation and positive T wave.There were no significant differences between the groups with respect to thrombolytic therapy and reperfusion criteria. In addition, 90% of the patients in group A (20/22), 66% in group B (12/18, P < 0.05 versus group A), and only 54% in group C (12/22, P < 0.01 versus group A) responded to LDSE. The infarct zone wall motion score index (WMSI) measured by LDSE was significantly decreased in group A compared to basal values (from 2.71 ± 0.65 to 2.07 ± 0.71 P = 0.02), and it was significantly different compared to groups B and C. Moreover, the serum creatinine kinase level of the patients in group C was higher (P < 0.01 versus group A), whereas the ejection fraction was inferior (group A 48%, group B 47%, and group C 41%, P = 0.04 versus group A). When the correlations between good left ventricular function and terminal QRS distortion, sum ST elevation, the number of leads with ST elevation, ST elevation shape on admission, and ST and T alterations in ECG at discharge were investigated, an independent correlation was found between ST and T alteration in ECG and a WMSI value < 2 at rest or after LDSE (P = 0.03, OR 3.08, 95%CI 1. 05-8.98).At the infarct zone of patients with ST elevation and positive T waves, left ventricular function is worse and the viability is less. This simple classification may be useful in predicting left ventricular function at the time of discharge. (Int Heart J 2005; 46: 961-973)

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confidence: 99%

Predischarge ST Segment and T Wave Patterns in Predicting Left Ventricular Function and Myocardial Viability in Q Wave Anterior Myocardial Infarction Patients

2005

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“…11) In the present study, early T wave inversion was documented in all patients and the new Q waves and poor r wave progression disappeared within several days. It is also apparent from the ECGs that spontaneous reperfusion occurred shortly after coronary occlusion.…”

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confidence: 75%

Clinicopathological Characteristics of Left Ventricular Myocardium with Transient Asynergy.

et al. 2001

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SUMMARYThe aim of the present retrospective study was to clarify the histopathologic substrates of left ventricular myocardium with transient asynergy due to acute ischemic insult in man.Three patients who had had prolonged chest pain, new abnormal Q waves and new ST segment elevation were studied. There was no significant elevation of serum creatine phosphokinase activity in two of the three patients. Echocardiograms on admission or the next day showed severe hypokinetic or akinetic motion and thinning of the anteroseptal and apical portions of the left ventricle and regional dilatation of the same portions. Disappearance of the abnormal Q waves, ST segment elevation resolution, and early T wave inversion were observed later. Complete improvement of the echocardiographic abnormalities was confirmed after a few weeks in all patients.Manifest ischemic lesions of subendocardial scars of the anteroseptal region of the left ventricle were detected in only one of the three cases by gross examination. However, on microscopic examination, islands of necrotic myocytes were interspersed with islands of viable cells throughout the jeopardized region in one case, although the scattered necrotic foci were restricted to the subendocardium and the trabeculae. Normal myocardium and subendocardial scars were observed in the other two cases.In conclusion, left ventricular myocardium with transient asynergy, detected clinically during acute ischemic attack, consists of normal myocardium or small ischemic lesions primarily in the subendocardium. (Jpn Heart J 2001; 42: 235-248)

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“…41 The development of negative T waves after reperfusion of AMI has been attributed to viable but sympathetically denervated myocardium, because sympathetic denervation delays repolarization. 42 We have previously shown that negative T waves progressively develop in both TC and reperfused anterior AMI during the subacute phase and are especially prominent in the former, suggesting that TC might be associated with more viable but sympathetically denervated myocardium. 41 …”

Section: Negative T Waves In Tcmentioning

confidence: 99%

Implications of Using the Cabrera Sequence for Diagnosing Acute Coronary Syndrome

Kosuge

Kimura

2016

Circ J

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The 12-lead electrocardiogram (ECG) is the important, initial examination for diagnosing acute coronary syndrome (ACS). In the traditional 12-lead ECG display, the precordial leads are displayed in their anatomically contiguous order, which makes it easy to understand the positional relationships between the precordial leads and the heart, but the limb leads are not. The "Cabrera sequence" displays the limb leads in an anatomically contiguous manner, which facilitates understanding of the positional relations between the limb leads and the heart, resulting in more rapid, easy, and accurate ECG interpretation than the traditional limb leads display. This review explores the clinical advantages of the Cabrera sequence as compared with the traditional limb leads display for the diagnosis of ACS. (Circ J 2016; 80: 1087 -1096

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Early T wave inversion after thrombolytic therapy predicts better coronary perfusion: Clinical and angiographic study

Abstract: Early inversion of T waves in patients with acute myocardial infarction treated with thrombolytic therapy suggests patency of the infarct-related artery, better perfusion grade and left ventricular function and a more benign in-hospital course.

Cited by 55 publications

References 34 publications

Predischarge ST Segment and T Wave Patterns in Predicting Left Ventricular Function and Myocardial Viability in Q Wave Anterior Myocardial Infarction Patients

Predischarge ST Segment and T Wave Patterns in Predicting Left Ventricular Function and Myocardial Viability in Q Wave Anterior Myocardial Infarction Patients

Clinicopathological Characteristics of Left Ventricular Myocardium with Transient Asynergy.

Implications of Using the Cabrera Sequence for Diagnosing Acute Coronary Syndrome

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