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Upright T waves in lead aVR are associated with cardiac death or hospitalization for heart failure in patients with a prior myocardial infarction

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Abstract

The aim of the present study was to clarify the prognostic significance of upright T waves (amplitude > 0 mV) in lead aVR in patients with a prior myocardial infarction (MI). We retrospectively examined 167 patients with a prior MI. The primary end point was cardiac death or hospitalization for heart failure. During a follow-up period of 6.5 ± 2.8 years, 34 patients developed the primary end point. A Kaplan–Meier analysis showed a lower primary event-free rate in patients with upright T waves in lead aVR than in those with nonupright T waves in lead aVR (P = 0.001). Univariate Cox proportional hazards regression analyses showed that age, gender, chronic kidney disease, anterior wall MI, upright T waves in lead aVR, left ventricular ejection fraction, loop diuretic use, and spironolactone use were significantly associated with the primary end point. A multivariate Cox proportional hazards regression analysis selected age [hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.05–1.16, P < 0.001], upright T waves in lead aVR (HR 3.10, 95% CI 1.23–7.82, P = 0.017), and loop diuretic use (HR 4.61, 95% CI 1.55–13.67, P = 0.006) as independent predictors of the primary end point. In conclusion, the presence of upright T waves in lead aVR is an independent predictor of cardiac death or hospitalization for heart failure in patients with a prior MI. The analysis of T-wave amplitude in lead aVR provides useful prognostic information in patients with a prior MI.

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Authors and Affiliations

  1. Internal Medicine 2, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu, 879-5593, Japan

    Kumie Torigoe, Akira Tamura, Yoshiyuki Kawano, Kazuhiro Shinozaki, Munenori Kotoku & Junichi Kadota

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  1. Kumie Torigoe
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  2. Akira Tamura
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  3. Yoshiyuki Kawano
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  4. Kazuhiro Shinozaki
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  5. Munenori Kotoku
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  6. Junichi Kadota
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Correspondence to Akira Tamura.

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Torigoe, K., Tamura, A., Kawano, Y. et al. Upright T waves in lead aVR are associated with cardiac death or hospitalization for heart failure in patients with a prior myocardial infarction. Heart Vessels 27, 548–552 (2012). https://doi.org/10.1007/s00380-011-0193-6

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  • DOI: https://doi.org/10.1007/s00380-011-0193-6

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