title: Prognostic significance of inverted T waves in patients with acute pulmonary embolism.
abstract: 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.
authors.affiliation: The Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Kosuge
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ebina
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hibi
authors.forename: Kengo
authors.initials: K
authors.lastname: Tsukahara
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kanna
authors.forename: Noriaki
authors.initials: N
authors.lastname: Iwahashi
authors.forename: Jyun
authors.initials: J
authors.lastname: Okuda
authors.forename: Naoki
authors.initials: N
authors.lastname: Nozawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ozaki
authors.forename: Hideto
authors.initials: H
authors.lastname: Yano
authors.forename: Tatuya
authors.initials: T
authors.lastname: Nakati
authors.forename: Ikuyoshi
authors.initials: I
authors.lastname: Kusama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: 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