Prognostic Significance of Inverted T Waves in Patients With Acute Pulmonary Embolism

Prognostic Significance of Inverted T Waves in Patients With Acute Pulmonary Embolism

Background The significance of inverted T waves remains unclear in patients with acute pulmonary embolism (PE). Methods and Results The relationship of the number of leads with inverted T waves to the severity of PE in 40 patients with acute PE was studied. Patients were classified into 3 groups acc...

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Published in:Circulation Journal Vol. 70; no. 6; pp. 750 - 755
Main Authors: Kosuge, Masami, Kimura, Kazuo, Ishikawa, Toshiyuki, Ebina, Toshiaki, Hibi, Kiyoshi, Tsukahara, Kengo, Kanna, Masahiko, Iwahashi, Noriaki, Okuda, Jyun, Nozawa, Naoki, Ozaki, Hiroyuki, Yano, Hideto, Nakati, Tatuya, Kusama, Ikuyoshi, Umemura, Satoshi
Format: Journal Article
Language:English
Published: Japan The Japanese Circulation Society 2006
Subjects:
Acute Disease
Adult
Aged
Aged, 80 and over
Electrocardiography
Female
Humans
Hypertension - complications
Hypertension - physiopathology
Hypertension - therapy
Male
Middle Aged
Predictive Value of Tests
Prognosis
Pulmonary embolis
Pulmonary Embolism - complications
Pulmonary Embolism - physiopathology
Pulmonary Embolism - therapy
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Summary:Background The significance of inverted T waves remains unclear in patients with acute pulmonary embolism (PE). Methods and Results The relationship of the number of leads with inverted T waves to the severity of PE in 40 patients with acute PE was studied. Patients were classified into 3 groups according to the number of leads with inverted T waves on the admission electrocardiogram (ECG): 15 patients, ≤3 leads (group L); 12 patients, 4-6 leads (group M); and 13 patients, ≥7 leads (group H). In groups L, M and H, the rates of right ventricular dysfunction on echocardiography were 47%, 92% and 100% (p<0.01), respectively, and the rates of in-hospital complicated events (including death or the need for catecholamine support, cardiopulmonary resuscitation or mechanical cardiovascular support because of hemodynamic instability) were 0%, 8% and 46% (p=0.004), respectively. On multivariate analysis, arterial hypotension at presentation (odds ratio (OR) 8.96, p=0.049) and inverted T waves in ≥7 leads on the admission ECG (OR 16.8, p=0.037) were the only independent predictors of in-hospital complicated events. Conclusions The number of leads with inverted T waves may be a useful and simple marker of increased risk for early complications in patients with acute PE. (Circ J 2006; 70: 750 - 755)
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ISSN:1346-9843
1347-4820
DOI:10.1253/circj.70.750