Open AccessAccuracy of Low Load Exercise‐Induced T Wave Normalization in Predicting the Presence of Contractile Reserve After an Anterior Myocardial Infarction
Author(s) -
Mobilia Gianni,
Donato Antonino,
Satullo Gaetano,
Cavallaro Lucio,
Buchberger Riccardo,
Grassi Rasario
Publication year - 2000
Publication title -
preventive cardiology
Language(s) - English
Resource type - Journals
eISSN - 1751-7141
pISSN - 1520-037X
DOI - 10.1111/j.1520-037x.2000.80379.x
Subject(s) - medicine , cardiology , myocardial infarction , dobutamine , normalization (sociology) , infarction , electrocardiography , qrs complex , hemodynamics , sociology , anthropology
Background and Methods. Exercise‐induced T wave normalization occurring at a low (≤ 50 watt) workload in infarct‐related electrocardiographic leads was studied in 30 consecutive patients with a recent transmural anterior acute myocardial infarction. Patients underwent both ergometric stress testing (within 30 days after the infarction) and low dose dobutamine echocardiography. The T wave normalization was considered significant when it occurred in at least two infarct‐related leads. A significant contractile reserve was considered present in an infarcted region when 50% or more of the dyskinetic segments functionally improved on exercise during dobutamine infusion.
Results. Eighteen patients showed exercise‐induced T wave normalization (group 1), and 12 patients did not (group 2). Myocardial contractile reserve in the infarct area was detected in 16 patients of group 1 (88%) and in 3 patients (25%) of group 2 (p=0.004). The overall sensitivity, specificity, and diagnostic accuracy of T wave normalization, as it reflects contractile reserve in the infarct area, were 84%, 82%, and 83%, respectively.
Conclusion. Low load exercise‐induced T wave normalization in infarct‐related leads appears to be an accurate marker of residual contractile reserve in the infarct area in patients with recent transmural acute anterior myocardial infarction.