Relationship between normalization of negative T waves on exercise ECG and residual myocardial viability in patients with previous myocardial infarction and no post-infarction angina.
The usefulness of normalization of negative T waves in exercise ECG was investigated as an index of myocardial viability in patients with previous myocardial infarction with no symptoms or ischemic ST-segment change during exercise test. A total of 39 patients, 20 with T-wave normalization (POS group) and 19 without T-wave normalization (NEG group) on exercise ECG. were studied. Myocardial viability was evaluated by thallium-201 single-photon emission computed tomography (SPECT) during exercise or at rest. We also assessed left ventricular ejection fraction (LVEF) by contrast ventriculography before (n=39) and after percutaneous transluminal coronary angioplasty (PTCA) (n=17). SPECT detected myocardial viability in 16 (80%) of the 20 patients in the POS group and in 4 (21%) of the 19 patients in the NEG group (p<0.01). LVEF increased after successful PTCA in the POS group (from 53+/-13% to 63+/-8%, p<0.025), but fell in the NEG group (from 57+/-10% to 51+/-8%). It is concluded that normalization of negative T waves on exercise ECG is a useful, simple index of myocardial viability in patients with previous myocardial infarction with no symptoms or ischemic ST-segment change during exercise testing.
Ajisaka
R
R
Department of Medicine, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Watanabe
S
S
Masuoka
T
T
Yamanouchi
T
T
Saitoh
T
T
Toyama
M
M
Takeda
T
T
Itai
Y
Y
Sugishita
Y
Y
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000503:physiopathology*; D004562:Electrocardiography; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology*