title: Associations of positive T wave in lead aVR with hemodynamic, coronary, and left ventricular angiographic findings in anterior wall old myocardial infarction.
abstract: BACKGROUND
  No information is available on the clinical significance of a positive T wave in lead aVR in myocardial infarction (MI). Accordingly, in the present study, we sought to clarify the associations of the positive T wave in lead aVR with hemodynamic, coronary angiographic, and left ventriculographic findings in anterior wall old MI.
  
  
  METHODS
  We examined 122 patients with anterior wall old MI who underwent diagnostic or follow-up cardiac catheterization including coronary angiography and left ventriculography. The patients were classified into the following 2 groups: patients with a positive (≥ 1mm) T wave in lead aVR (n=20, group A) and those without (n=102, group B).
  
  
  RESULTS
  Group A had higher pulmonary arterial, pulmonary capillary wedge, and left ventricular (LV) end-diastolic pressures and a lower cardiac index than group B. The prevalence of a long left anterior descending coronary artery (LAD) was higher in group A than in group B (60% vs 30.4%, p=0.01), and none of group A patients had an LAD that did not reach the apex. Group A had a lower LV ejection fraction than group B (36.4 ± 11.6% vs 48.4 ± 12.7%, p<0.001).
  
  
  CONCLUSIONS
  The positive T wave in lead aVR is related to severely reduced cardiac function, with an LAD wrapping the apex, in anterior wall old MI. Further studies are needed to clarify whether the positive T wave in lead aVR is associated with an adverse outcome in patients with anterior wall old MI.
authors.affiliation: Internal Medicine 2, Oita University, Yufu, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Shinozaki
authors.forename: Akira
authors.initials: A
authors.lastname: Tamura
authors.forename: Junichi
authors.initials: J
authors.lastname: Kadota
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology