Abstract 11584: Upright T Waves in Lead aVR are Associated with Cardiac Death or Hospitalization for Heart Failure in Prior Myocardial Infarction
Background: A previous study demonstrated that the upright T wave (amplitude >0 mV) in lead aVR may be a useful marker for predicting cardiovascular mortality. However, the prognostic significance of the wave in lead aVR has not yet been investigated in myocardial infarction (MI).
Methods: We examined the prognostic significance of upright T waves in lead aVR in 167 patients with prior MI. The primary end point was cardiac death or hospitalization for heart failure.
Results: During a follow-up period of 6.5 ± 2.8 years, 34 patients developed the primary end point. A Kaplan-Meier analysis showed that the primary event-free rate was lower in 27 patients with upright T waves in lead aVR than in 140 patients without the waves in lead aVR (p = 0.001). Univariate Cox proportional hazards regression analyses showed that age, male 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 endpoint. 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 endpoint.
Conclusions: The upright T wave in lead aVR is an independent predictor of cardiac death or hospitalization for heart failure in patients with prior MI. The analysis of T waves in lead aVR would provide useful prognostic information in prior MI.
- © 2011 by American Heart Association, Inc.