The natural history of postischemic T-wave inversion: a predictor of poor short-term prognosis?
BACKGROUND
This study followed up the natural history of T-wave inversion and assessed the short-term prognosis associated with the condition.


METHODS
Forty patients with acute ischemic syndrome, without infarction, and with postischemic T-wave inversion (group 1) were followed during the persistence (inverted T-wave period) and after the resolution of T-wave inversion (positive T-wave period). Another 40 patients with acute ischemic syndrome, without infarction and with normal T waves (group 2), were also followed.


RESULTS
Postischemic inverted T waves showed resolution within 3-21 days of presentation in 31 patients from group 1 on medical treatment alone. Further ischemic events (acute myocardial infarction, acute ischemic syndrome, angina pectoris, silent ischemia), inducible ischemia (during treadmill test), wall-motion abnormalities (demonstrated by echocardiography), all developing in the primarily ischemic myocardial area, were more frequent (P < 0.02) in group 1 patients during the inverted T-wave period compared with those experienced in the positive T-wave period of group 1 patients, and compared with group 2 patients.


CONCLUSIONS
In most patients on medical treatment, postischemic inverted T-waves tended to resolve within 3 weeks. The presence of postischemic inverted T waves appears to be an independent marker of further ischemic events.
Simon
K
K
Second Department of Internal Medicine, St. George's Hospital, Székesfehérvár, Hungary.
Hackett
D
D
Szelier
A
A
Szabó
P
P
Szépvölgyi
A
A
Turi
T
T
Sereg
M
M
Szatmáry
L
L
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D004359:Drug Therapy, Combination; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000534:rehabilitation; D011226:Pre-Excitation Syndromes / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D011379:Prognosis; D013997:Time Factors