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T wave abnormalities identify patients with previous lateral wall myocardial infarction and circumflex artery disease

Daniele Rovai1, Alessia Gimelli2, Michele Coceani2

  • 1Institute of Clinical Physiology, National Research Council (CNR), Via Moruzzi 1, Pisa, Italy.

Journal of Electrocardiology
|January 1, 2016
PubMed

Insights

T wave abnormalities can help diagnose previous lateral myocardial infarction, even when QRS morphology is inconclusive. This finding is crucial for identifying coronary artery disease, specifically Left Circumflex (LCx) artery occlusion.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Electrocardiography

Background:

  • Diagnosis of prior lateral myocardial infarction traditionally relies on QRS morphology.
  • Limitations exist in QRS morphology for detecting subtle or old infarctions.

Purpose of the Study:

  • To investigate the diagnostic utility of T wave abnormalities in identifying previous lateral myocardial infarction.
  • To assess the correlation between T wave changes and Left Circumflex (LCx) artery disease.

Main Methods:

  • 166 patients with suspected ischemic heart disease underwent ECG, myocardial perfusion scintigraphy, and coronary arteriography.
  • Exclusion criteria included bundle-branch block, hypertrophy, and paced rhythms.
  • Analysis focused on T wave amplitudes in specific ECG leads (V2-V6, Lead I, V6).

Main Results:

  • No lateral Q waves of necrosis were observed in most patients.
  • T wave amplitude criteria (≥0.6mV in V2-V6, ≤0mV in Lead I+V6) showed moderate sensitivity and high specificity for lateral infarction.
  • T wave amplitude ≤0mV in Lead I+V6 independently predicted infarction and LCx occlusion (AUC 0.72-0.74).

Conclusions:

  • T wave abnormalities are valuable indicators of previous lateral myocardial infarction.
  • Specific T wave patterns effectively identify Left Circumflex (LCx) artery disease.
  • ECG T wave analysis offers a non-invasive method for diagnosing lateral wall myocardial damage.
Abstract

Keywords:
Coronary angiographyElectrocardiographyMyocardial infarctionPerfusionScintigraphy

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