title: Clinical implications of T-wave inversion in an asymptomatic population undergoing annual medical screening (from the Korean Air Forces Electrocardiogram Screening).
abstract: This study aimed to determine prevalence, differentiate underlying causes, and identify the benign group in subjects with asymptomatic T-wave inversion (TWI). We retrospectively read 12-lead electrocardiograms from 3,929 consecutive asymptomatic men in the air force (3,929 participants, mean age 39.3 ± 8.7 years) who underwent medical screening at the Aerospace Medical Center, Korea, from September 2010 to August 2012. TWIs other than in right precordial leads (V1 and V2) were present in 23 men (0.6%). All subjects with persistent TWI for 1 year (n = 18) underwent additional study, with the exception of 1 patient who refused further evaluation. Of 17 subjects with investigated persistent TWI, 8 (47.1%) had an apically displaced papillary muscle, 5 (29.4%) exhibited idiopathic TWI, 3 (17.6%) had apical hypertrophic cardiomyopathy, and 1 (5.9%) had Maron type 2 hypertrophic cardiomyopathy with dynamic left ventricular outflow obstruction. The depth of TWI was significantly shallow in the benign group (idiopathic TWI, 1.6 ± 0.5 mm) compared with potentially nonbenign group (the others; 5.5 ± 3.3 mm, p = 0.021). Lateral lead TWI was significantly correlated with potentially nonbenign group (46% vs 0%, p = 0.049). In conclusion, asymptomatic TWI is not rare (0.6%), even in a healthy population such as Korean Air Force society, and at least 29.4% of subjects with TWI are considered to belong to the benign group that does not require aggressive evaluation and criteria of TWI ≤2 mm other than lateral leads without co-morbidity could help to distinguish the benign group from the potentially nonbenign group.
authors.affiliation: Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sung Su
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Vision 21 Cardiac and Vascular Center, Inje University College of Medicine, Ilsan Paik Hospital, Korea. Electronic address: mdchoiwonho@gmail.com.
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Vision 21 Cardiac and Vascular Center, Inje University College of Medicine, Ilsan Paik Hospital, Korea.
authors.forename: Hyung Yoon
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Korea.
authors.forename: Se Hun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Korea.
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Bang
authors.affiliation: Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Korea.
authors.forename: Kyung Wook
authors.initials: KW
authors.lastname: Kang
authors.affiliation: Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Korea.
authors.forename: Chang Ho
authors.initials: CH
authors.lastname: An
authors.affiliation: Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Korea.
authors.forename: Jung Gu
authors.initials: JG
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, Vision 21 Cardiac and Vascular Center, Inje University College of Medicine, Ilsan Paik Hospital, Korea.
authors.forename: Jae-Jin
authors.initials: JJ
authors.lastname: Kwak
authors.affiliation: Department of Internal Medicine, Vision 21 Cardiac and Vascular Center, Inje University College of Medicine, Ilsan Paik Hospital, Korea.
authors.forename: Sung Uk
authors.initials: SU
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, Vision 21 Cardiac and Vascular Center, Inje University College of Medicine, Ilsan Paik Hospital, Korea.
authors.forename: Joon Hyung
authors.initials: JH
authors.lastname: Doh
authors.affiliation: Department of Internal Medicine, Vision 21 Cardiac and Vascular Center, Inje University College of Medicine, Ilsan Paik Hospital, Korea.
authors.forename: June
authors.initials: J
authors.lastname: Namgung
authors.affiliation: Department of Internal Medicine, Vision 21 Cardiac and Vascular Center, Inje University College of Medicine, Ilsan Paik Hospital, Korea.
authors.forename: Sung Yun
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Vision 21 Cardiac and Vascular Center, Inje University College of Medicine, Ilsan Paik Hospital, Korea.
authors.forename: Won Ro
authors.initials: WR
authors.lastname: Lee
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000453:epidemiology / Q000503:physiopathology; D004562:Electrocardiography; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D012189:Retrospective Studies