title: Prominent T wave in V2 with respect to V6 as a sign of lateral myocardial infarction.
abstract: BACKGROUND
  In the absence of confounding electrocardiographic features, a prominent R wave in leads V1-V2 reflects a lateral myocardial infarction (MI). We hypothesized that repolarization abnormalities in V1-V2 could also reflect a lateral MI.
  
  
  METHODS
  We retrospectively selected a group of 57 patients with a recent or previous first Q-wave MI involving left ventricular (LV) inferior and/or lateral wall at contrast-enhanced cardiac magnetic resonance (CMR). The location and extent of the MI at CMR were compared with electrocardiographic features.
  
  
  RESULTS
  The infarction was located in the inferior wall in 12 patients (21%), in the lateral wall in 8 (14%), and in both walls in 37 patients (65%). Infarct size corresponded to 16.8 (SD 9.0%) of LV myocardium. Infarct extent in the inferior and lateral wall (8.3%, SD 7.2% vs. 8.4%, SD 7.5% of LV myocardium) did not differ significantly. Using multiple linear regression analysis, inferior Q-waves and inferior negative T waves were directly associated with infarct extent in the inferior wall (p = 0.014 and p = 0.010, respectively). A prominent R wave in V1 and a prominent anterior T wave (expressed by the T wave amplitude in V2 minus its amplitude in V6) were directly associated with MI extent in the lateral wall (p = 0.008 and p = 0.018), while inferior negative T waves were negatively associated (p = 0.006).
  
  
  CONCLUSIONS
  In patients with MI of the inferior and/or lateral wall, a prominent T wave in V2 with respect to V6 reflects greater infarct extent in the lateral wall.
authors.affiliation: CNR, Clinical Physiology Institute, Via Moruzzi 1, 56124 Pisa, Italy. Electronic address: drovai@ifc.cnr.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Rovai
authors.affiliation: CNR, Clinical Physiology Institute, Via Moruzzi 1, 56124 Pisa, Italy. Electronic address: rossigi@ifc.cnr.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Pederzoli Hospital, Via Monte Baldo 24, 37019 Peschiera del Garda, Italy. Electronic address: lpederzoli@yahoo.it.
authors.forename: Laura
authors.initials: L
authors.lastname: Pederzoli
authors.affiliation: Fondazione Toscana Gabriele Monasterio, Via Trieste 41, 56126 Pisa, Italy. Electronic address: aquaro@ftgm.it.
authors.forename: Giovanni Donato
authors.initials: GD
authors.lastname: Aquaro
authors.affiliation: Department Clinical and Experimental Medicine, Section of Cardiology, University of Messina, Via C. Valeria, 98125 Messina, Italy. Electronic address: gianluca.dibella@tiscali.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Bella
authors.affiliation: CNR, Clinical Physiology Institute, Via Moruzzi 1, 56124 Pisa, Italy. Electronic address: pingi@ifc.cnr.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pingitore
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000175:diagnosis; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009203:Myocardial Infarction / Q000175:diagnosis*; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
keywords: Electrocardiogram; Magnetic resonance; Myocardial infarction; T wave