The T Wave Inversion Score Is Useful for Evaluating the Time-Course of Acute Pulmonary Embolism

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Background: The 12-lead electrocardiogram (ECG) has relatively poor specificity for identifying acute pulmonary embolism (APE). The aim of this study was to investigate ECG abnormalities according to 2 different criteria and their usefulness for assessing changes in APE. Methods and Results: Fifty-two APE patients underwent ECG examinations in the acute and chronic phases. ECG abnormalities were assessed according to Steins criteria (QRS complex abnormalities and T wave inversion in any lead except aVL, III, aVR, or V1) and Kosuges criteria (T wave inversion in any lead except aVR or aVL). Many patients had electrocardiographic abnormalities in the acute phase, but no specific abnormalities were found. According to Kosuges criteria, the frequency of T wave inversion was higher than that of abnormal QRS complexes and T wave inversion according to Steins criteria (P<0.01). In 20 cases with preclinical ECG records, the time-course of changes in the T wave inversion score (total numbers of T wave inversions per patient) was examined. The peak T wave inversion score was noted at 3 days after onset (P<0.01). Conclusions: These results suggest that the T wave inversion score, calculated according to Kosuges criteria, is useful for predicting the time-course of APE. (Circ J 2011; 75: 1222-1226)
社団法人　日本循環器学会の論文
2011-04-25