Upright T wave in precordiai lead V1 indicates the presence of significant coronary artery disease in patients undergoing coronary angiography with otherwise unremarkable electrocardiogram

摘要

The resting electrocardiogram (ECG) has limited ability to predict significant coronary artery disease (CAD) in the absence of dynamic changes of the ST segment and T wave. The T wave in precordiai lead V1 (TV1) reflects the net repo-larization forces of the anterior and posterior myocardial surfaces, and can be positive, negative, or biphasic [1]. It has been shown that concomitant right ventricular involvement in an acute infer-oposterior myocardial infarction (MI) is associated with upright TV1 [2]. Furthermore, it was reported that an upright TV1 is common in patients with left circumflex (LCx) coronary artery disease [3]. However, these studies included both patients with and without ECG signs of transmural infarction. Hence, it remains unknown whether the upright TV1 is able to predict the presence of significant coronary artery stenosis in patients with suspected CAD and otherwise unremarkable ECG. Thus, we sought to determine the relationship between upright TV1 and the occurrence of significant CAD in patients scheduled for coronary angiography, with otherwise normal resting ECG.