Key result
Body surface T wave maps detect abnormalities in ~50% of rest angina and pinpoint culprit arteries.
Why the study?
The clinical significance of T wave map changes in patients with angina at rest and single-vessel coronary artery disease was not well defined.
Does body surface T wave mapping indicate the involved coronary artery in patients with angina pectoris?
Cross-Sectional (n=187)
Does body surface T wave mapping indicate the involved coronary artery in patients with angina pectoris?
Body surface T wave mapping can identify the specific involved coronary artery in approximately half of patients with angina pectoris at rest.
May support noninvasive artery localization in select resting angina cases; leaves open prospective validation before clinical adoption.
To define the clinical significance of T wave map changes in patients with angina at rest, body surface isopotential T distributions were obtained in 48 patients with single-vessel disease (left anterior descending artery, 34; right coronary artery, eight; left circumflex artery, six) documented angiographically and were compared with those in 120 healthy subjects and those in 19 patients with left ventricular overload whose electrocardiograms showed negative T waves accompanied by an increase in R wave amplitude in left precordial leads. The T wave map abnormalities were observed in 24 of 48 patients (50%) with angina and were classified into three types: (1) type I (18 patients, 37.5%) was characterized by a segmental negative potential in the positive area located at the left thorax and the minimum at the peak of T wave positioned in the upper portion of the left anterior chest, (2) type II (three patients, 6.3%) was characterized by a negative potential with a minimum in the inferior thorax and an indentation of negative potential at the lower margin of the positive potential located over the upper thorax, and (3) type III (three patients, 6.3%) was characterized by a negative potential with a minimum at the back throughout the period of T wave. All patients showing T wave map abnormalities of type I had a significant stenosis of the left anterior descending artery. Likewise, all patients with type II or III had single-vessel disease of the right coronary or left circumflex artery, respectively. All types of T wave map changes observed in patients with angina were different from those in patients with left ventricular overload, whose maps showed the generalized negative potential at the inferior thorax and the left back and the minima clustered at the precordium. In seven patients with lesions of the left anterior descending artery, T wave map abnormalities of type I recovered to normal after successful percutaneous transluminal coronary angioplasty. The behavior of the negative potential and its extrema on the T wave map, which was not available from routine electrocardiography, was indicative of the involved coronary artery and probably of its associated ischemic area in one-half of our patients with angina pectoris.
No takes yet. Share an insight, caveat, or question.
Ishikawa et al. (1988) conducted a cross-sectional in Angina pectoris (n=187). T wave map (body surface isopotential T distributions) vs. Healthy subjects and patients with left ventricular overload was evaluated on T wave map abnormalities. Body surface T wave map abnormalities were present in 50% of patients with angina at rest and accurately identified the specific involved coronary artery.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: