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Clinical utility of aVR lead T-wave in electrocardiogram of patients with ST-elevation myocardial infarction

BACKGROUND: aVR lead is often neglected in routine clinical practice largely because of its undefined clinical utility specifications. Nevertheless, positive T-wave in aVR lead has been reported to be associated with poor clinical outcomes in some cardiovascular diseases. This study aimed to prospec...

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Autores principales: Kazemi, Babak, Sadat-Ebrahimi, Seyyed-Reza, Ranjbar, Abdolmohammad, Akbarzadeh, Fariborz, Sadaie, M. Reza, Safaei, Naser, Esmaeil zadeh-Saboor, Mehdi, Sohrabi, Bahram, Ghaffari, Samad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555143/
https://www.ncbi.nlm.nih.gov/pubmed/34706673
http://dx.doi.org/10.1186/s12872-021-02335-5
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author Kazemi, Babak
Sadat-Ebrahimi, Seyyed-Reza
Ranjbar, Abdolmohammad
Akbarzadeh, Fariborz
Sadaie, M. Reza
Safaei, Naser
Esmaeil zadeh-Saboor, Mehdi
Sohrabi, Bahram
Ghaffari, Samad
author_facet Kazemi, Babak
Sadat-Ebrahimi, Seyyed-Reza
Ranjbar, Abdolmohammad
Akbarzadeh, Fariborz
Sadaie, M. Reza
Safaei, Naser
Esmaeil zadeh-Saboor, Mehdi
Sohrabi, Bahram
Ghaffari, Samad
author_sort Kazemi, Babak
collection PubMed
description BACKGROUND: aVR lead is often neglected in routine clinical practice largely because of its undefined clinical utility specifications. Nevertheless, positive T-wave in aVR lead has been reported to be associated with poor clinical outcomes in some cardiovascular diseases. This study aimed to prospectively investigate the prognostic value and clinical utility of T-wave amplitude in aVR lead in patients with acute ST-elevation myocardial infarction (STEMI). METHODS: A total of 340 STEMI patients admitted to a tertiary heart center were consecutively included. Patients were categorized into four strata, based on T wave amplitude in aVR lead in their admission ECG (i.e. < − 2, − 1 to − 2, − 1 to 0, and ≥ 0 mV). Patients’ clinical outcomes were also recorded and statistically analyzed. RESULTS: In-hospital mortality, re-hospitalization, and six-month-mortality significantly varied among four T wave strata and were higher in patients with a T wave amplitude of ≥ 0 mV (p 0.001–0.002). The groups of patients with higher T wave amplitude in aVR, had progressively increased relative risk (RR) of in-hospital mortality (RRs ≤ 0.01, 0.07, 1.00, 2.30 in four T wave strata, respectively). T wave amplitude in the cutoff point of − 1 mV exhibited a sensitivity and specificity of 95.83 (95% CI 78.88–99.89) and 49.68 (95% CI 44.04–55.33). CONCLUSION: Our study demonstrated a significant association of positive T wave in aVR lead and adverse clinical outcomes in STEMI patients. Nevertheless, the clinical utility of T-wave amplitude at aVR lead is limited by its low discriminative potential toward prognosis of STEMI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-021-02335-5.
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spelling pubmed-85551432021-10-29 Clinical utility of aVR lead T-wave in electrocardiogram of patients with ST-elevation myocardial infarction Kazemi, Babak Sadat-Ebrahimi, Seyyed-Reza Ranjbar, Abdolmohammad Akbarzadeh, Fariborz Sadaie, M. Reza Safaei, Naser Esmaeil zadeh-Saboor, Mehdi Sohrabi, Bahram Ghaffari, Samad BMC Cardiovasc Disord Research BACKGROUND: aVR lead is often neglected in routine clinical practice largely because of its undefined clinical utility specifications. Nevertheless, positive T-wave in aVR lead has been reported to be associated with poor clinical outcomes in some cardiovascular diseases. This study aimed to prospectively investigate the prognostic value and clinical utility of T-wave amplitude in aVR lead in patients with acute ST-elevation myocardial infarction (STEMI). METHODS: A total of 340 STEMI patients admitted to a tertiary heart center were consecutively included. Patients were categorized into four strata, based on T wave amplitude in aVR lead in their admission ECG (i.e. < − 2, − 1 to − 2, − 1 to 0, and ≥ 0 mV). Patients’ clinical outcomes were also recorded and statistically analyzed. RESULTS: In-hospital mortality, re-hospitalization, and six-month-mortality significantly varied among four T wave strata and were higher in patients with a T wave amplitude of ≥ 0 mV (p 0.001–0.002). The groups of patients with higher T wave amplitude in aVR, had progressively increased relative risk (RR) of in-hospital mortality (RRs ≤ 0.01, 0.07, 1.00, 2.30 in four T wave strata, respectively). T wave amplitude in the cutoff point of − 1 mV exhibited a sensitivity and specificity of 95.83 (95% CI 78.88–99.89) and 49.68 (95% CI 44.04–55.33). CONCLUSION: Our study demonstrated a significant association of positive T wave in aVR lead and adverse clinical outcomes in STEMI patients. Nevertheless, the clinical utility of T-wave amplitude at aVR lead is limited by its low discriminative potential toward prognosis of STEMI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-021-02335-5. BioMed Central 2021-10-28 /pmc/articles/PMC8555143/ /pubmed/34706673 http://dx.doi.org/10.1186/s12872-021-02335-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Kazemi, Babak
Sadat-Ebrahimi, Seyyed-Reza
Ranjbar, Abdolmohammad
Akbarzadeh, Fariborz
Sadaie, M. Reza
Safaei, Naser
Esmaeil zadeh-Saboor, Mehdi
Sohrabi, Bahram
Ghaffari, Samad
Clinical utility of aVR lead T-wave in electrocardiogram of patients with ST-elevation myocardial infarction
title Clinical utility of aVR lead T-wave in electrocardiogram of patients with ST-elevation myocardial infarction
title_full Clinical utility of aVR lead T-wave in electrocardiogram of patients with ST-elevation myocardial infarction
title_fullStr Clinical utility of aVR lead T-wave in electrocardiogram of patients with ST-elevation myocardial infarction
title_full_unstemmed Clinical utility of aVR lead T-wave in electrocardiogram of patients with ST-elevation myocardial infarction
title_short Clinical utility of aVR lead T-wave in electrocardiogram of patients with ST-elevation myocardial infarction
title_sort clinical utility of avr lead t-wave in electrocardiogram of patients with st-elevation myocardial infarction
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555143/
https://www.ncbi.nlm.nih.gov/pubmed/34706673
http://dx.doi.org/10.1186/s12872-021-02335-5
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