BACKGROUND: The significance of inverted T waves remains unclear in patients with acute pulmonary embolism (PE). METHODS AND RESULTS: The relationship of the number of leads with inverted T waves to the severity of PE in 40 patients with acute PE was studied. Patients were classified into 3 groups according to the number of leads with inverted T waves on the admission electrocardiogram (ECG): 15 patients, <or=3 leads (group L); 12 patients, 4-6 leads (group M); and 13 patients, >or=7 leads (group H). In groups L, M and H, the rates of right ventricular dysfunction on echocardiography were 47%, 92% and 100% (p<0.01), respectively, and the rates of in-hospital complicated events (including death or the need for catecholamine support, cardiopulmonary resuscitation or mechanical cardiovascular support because of hemodynamic instability) were 0%, 8% and 46% (p=0.004), respectively. On multivariate analysis, arterial hypotension at presentation (odds ratio (OR) 8.96, p=0.049) and inverted T waves in >or=7 leads on the admission ECG (OR 16.8, p=0.037) were the only independent predictors of in-hospital complicated events. CONCLUSIONS: The number of leads with inverted T waves may be a useful and simple marker of increased risk for early complications in patients with acute PE.
BACKGROUND: The significance of inverted T waves remains unclear in patients with acute pulmonary embolism (PE). METHODS AND RESULTS: The relationship of the number of leads with inverted T waves to the severity of PE in 40 patients with acute PE was studied. Patients were classified into 3 groups according to the number of leads with inverted T waves on the admission electrocardiogram (ECG): 15 patients, <or=3 leads (group L); 12 patients, 4-6 leads (group M); and 13 patients, >or=7 leads (group H). In groups L, M and H, the rates of right ventricular dysfunction on echocardiography were 47%, 92% and 100% (p<0.01), respectively, and the rates of in-hospital complicated events (including death or the need for catecholamine support, cardiopulmonary resuscitation or mechanical cardiovascular support because of hemodynamic instability) were 0%, 8% and 46% (p=0.004), respectively. On multivariate analysis, arterial hypotension at presentation (odds ratio (OR) 8.96, p=0.049) and inverted T waves in >or=7 leads on the admission ECG (OR 16.8, p=0.037) were the only independent predictors of in-hospital complicated events. CONCLUSIONS: The number of leads with inverted T waves may be a useful and simple marker of increased risk for early complications in patients with acute PE.
Authors: Geneviève C Digby; Piotr Kukla; Zhong-Qun Zhan; Carlos A Pastore; Ryszard Piotrowicz; Edgardo Schapachnik; Wojciech Zareba; Antonio Bayés de Luna; Piotr Pruszczyk; Adrian M Baranchuk Journal: Ann Noninvasive Electrocardiol Date: 2015-05 Impact factor: 1.468
Authors: Karin Janata; Thomas Höchtl; Catharina Wenzel; Rudolf Jarai; Barbara Fellner; Alexander Geppert; Peter Smetana; Vera Havranek; Kurt Huber Journal: Clin Res Cardiol Date: 2011-12-22 Impact factor: 5.460
Authors: Keith Todd; Christopher S Simpson; Damian P Redfearn; Hoshiar Abdollah; Adrian Baranchuk Journal: Indian Pacing Electrophysiol J Date: 2009-09-01