학술논문
Clinical utility of aVR lead T-wave in electrocardiogram of patients with ST-elevation myocardial infarction
augmented unipolar right arm lead
augmented unipolar right arm lead
Document Type
Report
Author
Source
BMC Cardiovascular Disorders. October 28, 2021, Vol. 21 Issue 1
Subject
Language
English
ISSN
1471-2261
Abstract
Author(s): Babak Kazemi[sup.1] , Seyyed-Reza Sadat-Ebrahimi[sup.1] , Abdolmohammad Ranjbar[sup.1] , Fariborz Akbarzadeh[sup.1] , M. Reza Sadaie[sup.2] , Naser Safaei[sup.1] , Mehdi Esmaeil zadeh-Saboor[sup.1] , Bahram Sohrabi[sup.1] and Samad Ghaffari[sup.1] Introduction [...]
Background aVR lead is often neglected in routine clinical practice largely because of its undefined clinical utility specifications. Nevertheless, positive T-wave in aVR lead has been reported to be associated with poor clinical outcomes in some cardiovascular diseases. This study aimed to prospectively investigate the prognostic value and clinical utility of T-wave amplitude in aVR lead in patients with acute ST-elevation myocardial infarction (STEMI). Methods A total of 340 STEMI patients admitted to a tertiary heart center were consecutively included. Patients were categorized into four strata, based on T wave amplitude in aVR lead in their admission ECG (i.e. < - 2, - 1 to - 2, - 1 to 0, and [greater than or equai to] 0 mV). Patients' clinical outcomes were also recorded and statistically analyzed. Results In-hospital mortality, re-hospitalization, and six-month-mortality significantly varied among four T wave strata and were higher in patients with a T wave amplitude of [greater than or equai to] 0 mV (p 0.001-0.002). The groups of patients with higher T wave amplitude in aVR, had progressively increased relative risk (RR) of in-hospital mortality (RRs [less than or equai to] 0.01, 0.07, 1.00, 2.30 in four T wave strata, respectively). T wave amplitude in the cutoff point of - 1 mV exhibited a sensitivity and specificity of 95.83 (95% CI 78.88-99.89) and 49.68 (95% CI 44.04-55.33). Conclusion Our study demonstrated a significant association of positive T wave in aVR lead and adverse clinical outcomes in STEMI patients. Nevertheless, the clinical utility of T-wave amplitude at aVR lead is limited by its low discriminative potential toward prognosis of STEMI. Keywords: ST-elevation myocardial infarction, Electrocardiogram, T wave, aVR lead, Prognosis
Background aVR lead is often neglected in routine clinical practice largely because of its undefined clinical utility specifications. Nevertheless, positive T-wave in aVR lead has been reported to be associated with poor clinical outcomes in some cardiovascular diseases. This study aimed to prospectively investigate the prognostic value and clinical utility of T-wave amplitude in aVR lead in patients with acute ST-elevation myocardial infarction (STEMI). Methods A total of 340 STEMI patients admitted to a tertiary heart center were consecutively included. Patients were categorized into four strata, based on T wave amplitude in aVR lead in their admission ECG (i.e. < - 2, - 1 to - 2, - 1 to 0, and [greater than or equai to] 0 mV). Patients' clinical outcomes were also recorded and statistically analyzed. Results In-hospital mortality, re-hospitalization, and six-month-mortality significantly varied among four T wave strata and were higher in patients with a T wave amplitude of [greater than or equai to] 0 mV (p 0.001-0.002). The groups of patients with higher T wave amplitude in aVR, had progressively increased relative risk (RR) of in-hospital mortality (RRs [less than or equai to] 0.01, 0.07, 1.00, 2.30 in four T wave strata, respectively). T wave amplitude in the cutoff point of - 1 mV exhibited a sensitivity and specificity of 95.83 (95% CI 78.88-99.89) and 49.68 (95% CI 44.04-55.33). Conclusion Our study demonstrated a significant association of positive T wave in aVR lead and adverse clinical outcomes in STEMI patients. Nevertheless, the clinical utility of T-wave amplitude at aVR lead is limited by its low discriminative potential toward prognosis of STEMI. Keywords: ST-elevation myocardial infarction, Electrocardiogram, T wave, aVR lead, Prognosis