Prognostic significance of inverted T waves in patients with acute pulmonary embolism.
BACKGROUND
The significance of inverted T waves remains unclear in patients with acute pulmonary embolism (PE).


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.
Kosuge
Masami
M
The Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Kimura
Kazuo
K
Ishikawa
Toshiyuki
T
Ebina
Toshiaki
T
Hibi
Kiyoshi
K
Tsukahara
Kengo
K
Kanna
Masahiko
M
Iwahashi
Noriaki
N
Okuda
Jyun
J
Nozawa
Naoki
N
Ozaki
Hiroyuki
H
Yano
Hideto
H
Nakati
Tatuya
T
Kusama
Ikuyoshi
I
Umemura
Satoshi
S
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011655:Pulmonary Embolism / Q000150:complications / Q000503:physiopathology* / Q000628:therapy