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

Autor: Yoshiyuki Kawano, Jun-ichi Kadota, Akira Tamura, Munenori Kotoku, Kumie Torigoe, Kazuhiro Shinozaki
Rok vydání: 2011
Předmět:
Male
medicine.medical_specialty
Time Factors
Kaplan-Meier Estimate
Spironolactone
Risk Assessment
Disease-Free Survival
Ventricular Function
Left
Electrocardiography
Sex Factors
Sodium Potassium Chloride Symporter Inhibitors
Predictive Value of Tests
Risk Factors
Internal medicine
T wave
medicine
Humans
Myocardial infarction
Renal Insufficiency
Chronic
Anterior Wall Myocardial Infarction
Aged
Mineralocorticoid Receptor Antagonists
Proportional Hazards Models
Retrospective Studies
Heart Failure
Chi-Square Distribution
Ejection fraction
medicine.diagnostic_test
Proportional hazards model
business.industry
Hazard ratio
Age Factors
Stroke Volume
Stroke volume
Middle Aged
Prognosis
medicine.disease
Hospitalization
Death
Sudden
Cardiac
Heart failure
Multivariate Analysis
Ventricular Fibrillation
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Heart and Vessels. 27:548-552
ISSN: 1615-2573
0910-8327
DOI: 10.1007/s00380-011-0193-6
Popis: 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.
Databáze: OpenAIRE
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