title: The T wave inversion score is useful for evaluating the time-course of acute pulmonary embolism.
abstract: BACKGROUND
  The 12-lead electrocardiogram (ECG) has relatively poor specificity for identifying acute pulmonary embolism (APE). The aim of this study was to investigate ECG abnormalities according to 2 different criteria and their usefulness for assessing changes in APE.
  
  
  RESULTS
  Fifty-two APE patients underwent ECG examinations in the acute and chronic phases. ECG abnormalities were assessed according to Stein's criteria (QRS complex abnormalities and T wave inversion in any lead except aV(L), III, aV(R), or V₁) and Kosuge's criteria (T wave inversion in any lead except aV(R) or aV(L)). Many patients had electrocardiographic abnormalities in the acute phase, but no specific abnormalities were found. According to Kosuge's criteria, the frequency of T wave inversion was higher than that of abnormal QRS complexes and T wave inversion according to Stein's criteria (P < 0.01). In 20 cases with preclinical ECG records, the time-course of changes in the T wave inversion score (total numbers of T wave inversions per patient) was examined. The peak T wave inversion score was noted at 3 days after onset (P < 0.01).
  
  
  CONCLUSIONS
  These results suggest that the T wave inversion score, calculated according to Kosuge's criteria, is useful for predicting the time-course of APE.
authors.affiliation: The Fourth Department of Internal Medicine, Teikyo University School of Medicine, Kawasaki, Japan. t2kuni@med.teikyo-u.ac.jp
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kunishima
authors.forename: Yoshihiro J
authors.initials: YJ
authors.lastname: Akashi
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Miyake
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Aoyama
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Kohshoh
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshino
authors.forename: Kenji
authors.initials: K
authors.lastname: Seki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Taiji
authors.initials: T
authors.lastname: Furukawa
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Amano
authors.forename: Isao
authors.initials: I
authors.lastname: Taguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugimura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Murakawa
mesh_terms: D000208:Acute Disease; D000368:Aged; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000175:diagnosis*; D013997:Time Factors