Reevaluation of an Old Electrocardiographic Criterion for Coronary Disease: TV 1 > TV 6

Background: Two different studies were conducted to evaluate the value of T wave in V 1 taller than T wave in V 6 (TV 1 > TV 6 ) pattern as an indicator of coronary artery disease. Method: In the first study 5,300 resting ECGs were examined and the criterion was found in 283 patients. All of these patients were examined with echocardiography. In the second study, ECG tracings and coronary angiograms of another 500 patients were evaluated. Results: In the first study, in 59 of 283 patients left ventricular hypertrophy was detected and these patients were excluded from the study. There were ST segment‐T wave changes and/or Q wave on ECG suggesting coronary ischemia or myocardial infarction in 160 of the 224 patients. TV 1 , > TV 6 criterion was the sole finding in 64 of the 224 patients. All of the 224 patients underwent coronary angiography and coronary artery disease was detected in 185 patients; 134 of the 160 patients (83.3%) and 51 of 64 patients (80%) had one‐vessel or multivessel disease. There was no significant difference among the groups regarding coronary artery disease. Left anterior descending artery was involved in all of the 185 patients. In the second study, 408 patients were found to have coronary disease involvement and 92 patients showed normal or insignificant coronary disease. Sixty‐six of the 408 patients with coronary disease and four of 92 patients were found to have the TV 1 > TV 6 pattern. Sensitivity of the criterion was 16.1%, specificity was 95.6%, and accuracy was 94.2%. Conclusions: According to these results, it is concluded that TV 1 > TV 6 with or without other ECG findings is a good criterion suggesting coronary artery disease, especially left anterior descending artery involvement in patients without left ventricular hypertrophy. A.N.E. 1999;4(4):397–400