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      The Deeper the Negativity of the T Waves Recorded, the Greater Is the Effectiveness of Reperfusion of the Myocardium

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          Abstract

          We evaluated the time course of QT intervals and the amplitude of T waves, and their relationship to subsequent left ventricular regional wall motions in 88 patients with successfully reperfused acute myocardial infarction (MI). The QTc intervals and the amplitude of inverted T waves of lead V<sub>3</sub> in patients with anterior MI and of lead III in patients with inferior MI were measured for 1 month after MI. Patients were classified as having severe T wave inversion or mild T wave inversion within 3 days of MI, based on a measurement of 0.5 mV in the anterior MI cases and 0.3 mV in the inferior MI cases. Chronic-phase left ventriculography was performed 5 months later, and hypokinesis of the infarct site was measured using the centerline method. The T waves inverted after reperfusion in 86 patients (98%). The inverted T waves deepened twice, with the first negative peak about 48 h and the second negative peak about 18 days after MI. QTc intervals became prolonged as the T waves deepened. The extent of hypokinesis in the chronic phase correlated with the amplitude of inverted T waves and QTc intervals when the T waves were deepest. The group with severe T wave inversion had less extensive hypokinesis, a lower maximum serum creatine kinase level and a shorter time to reperfusion from the onset of symptoms than the group with mild inversion. We conclude that the degree of T wave inversion 48 h after MI is predictive of abnormalities in left ventricular regional wall motions in the chronic phase. A deep inverted T wave in the acute phase of MI indicates an abundantly stunned myocardium.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1996
          1996
          19 November 2008
          : 87
          : 2
          : 91-97
          Affiliations
          First Department of Internal Medicine, Nara Medical University, Kashihara, Japan
          Article
          177069 Cardiology 1996;87:91–97
          10.1159/000177069
          8653736
          © 1996 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 7
          Categories
          Noninvasive and Diagnostic Cardiology

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