Relation of T wave polarity in precordial V1 lead to right coronary pathoanatomy in inferoposterior wall acute myocardial infarction

To test the hypothesis that right ventricular (RV) involvement may affect precordial T wave polarity, the relationship of T wave polarity in lead V1 to right coronary pathoanatomy was examined in 61 patients with first inferoposterior wall acute myocardial infarction (AMI) due to right coronary occl...

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Bibliographic Details
Published inJournal of cardiology Vol. 24; no. 1; p. 17
Main Authors Kataoka, H, Tamura, A, Mikuriya, Y
Format Journal Article
LanguageJapanese
Published Netherlands 01.01.1994
Subjects
Aged
Constriction, Pathologic
Coronary Angiography
Coronary Vessels - pathology
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction - pathology
Myocardial Infarction - physiopathology
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Summary:To test the hypothesis that right ventricular (RV) involvement may affect precordial T wave polarity, the relationship of T wave polarity in lead V1 to right coronary pathoanatomy was examined in 61 patients with first inferoposterior wall acute myocardial infarction (AMI) due to right coronary occlusion within 5 hours of symptom onset. One hundred healthy subjects served as normal controls. The patients were divided into two major groups based on the site of right coronary occlusion: group A (n = 34) with proximal occlusion and group B (n = 27) with distal occlusion. Each major group was classified into two subgroups according to the direction of the ST segment shift in lead V1. Group A was divided into subgroups A1 (27 patients with isoelectric or ST segment elevation) and A2 (7 patients with ST segment depression), and group B into subgroups B1 (8 patients with isoelectric or ST segment elevation) and B2 (19 patients with ST segment depression). The incidence of upright T wave in lead V1 (> or = 0.15 mV) was higher in the patients with proximal right coronary occlusion (70.6%) than in the controls (27%) (p < 0.001) or the patients with distal right coronary occlusion (18.5%) (p < 0.001). Upright T wave occurred most frequently in subgroup A1 (89%) (p < 0.001 vs controls), and least in subgroup B2 (6%) (p < 0.05 vs controls). T wave polarity agreed with the direction of the ST segment shift in 40 of 61 AMI patients (66%) and disagreed in only one patient (2%).(ABSTRACT TRUNCATED AT 250 WORDS)
ISSN:0914-5087