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Postextrasystolic T wave changes and angiographic coronary disease
Insights
Postextrasystolic T wave changes, observed after induced extrasystoles, are not reliable indicators for diagnosing or localizing coronary artery disease in patients. These changes occur frequently even in individuals with healthy coronary arteries.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Postextrasystolic T wave changes are electrocardiographic findings that may indicate myocardial issues.
- Their diagnostic utility in coronary artery disease (CAD) requires further investigation.
Purpose of the Study:
- To evaluate the significance of postextrasystolic T wave changes in diagnosing and localizing coronary artery disease.
Main Methods:
- Assessed postextrasystolic T wave changes in 55 patients using electrocardiography and coronary angiography.
- Correlated T wave changes with the presence and location of coronary artery stenosis.
Main Results:
- T wave changes were present in 81% of CAD patients and 68% of patients with normal coronary arteries.
- No significant difference in T wave changes was observed between normal and stenosed coronary arteries (54% vs. 55%).
- Left ventricular asynergy was not associated with increased T wave changes.
Conclusions:
- Postextrasystolic T wave changes are not a reliable diagnostic tool for coronary artery disease.
- These findings do not aid in localizing coronary artery disease due to their high prevalence in normal arteries.
Abstract:
The significance of postextrasystolic T wave changes in beats following induced extrasystoles was assessed by angiography in 55 patients. These T wave changes were found in 81 per cent of coronary artery disease patients but also in 68 per cent of patients with normal coronary arteries (PNS). All patients with normal baseline electrocardiograms and normal coronary arteries showed postextrasystolic T wave changes. In electrocardiographic leads corresponding to the distribution of major coronary arteries, T wave changes occurred just as frequently when the artery was normal (54%) as when the artery was stenosed (55%). Left ventricular asynergy was not associated with an increased frequency of postextrasystolic T wave changes and in fact ejection fraction was greater end-diastolic pressure lower in patients with T wave changes. Thus, postextrasystolic T wave changes appear not to be useful in diagnosing or localising coronary artery disease.