Iranian Heart Journal

Iranian Heart Journal

Relationship Between a Positive T Wave in the Precordial V1 Lead and Advanced Coronary Artery Disease and 1-Year Mortality in Patients Undergoing Elective Coronary Angiography: An Observational Study

Document Type : Original Article

Authors
Elnaz Javanshir
Vida Vatankhahan
Javad Mohammad alizadeh
Mehrdad Raadi
Ahmad Separham
Cardiovascular Research Center, Tabriz University of Medical Science, Madani Heart Center, Cardiology Department, Tabriz, IR Iran.
Abstract
Background: Data are scarce regarding the association between a positive T wave in the precordial lead V1 (TV1) and the severity of coronary artery disease (CAD) and long-term mortality in patients with suspected CAD and otherwise normal electrocardiograms (ECGs). The present study aimed to assess the association between a positive TV1 and the severity of coronary artery stenosis and 1-year mortality in patients with normal ECGs undergoing elective coronary angiography.
 
Methods: The present retrospective study enrolled 500 patients referred for elective coronary angiography and normal ECGs. We excluded patients with a history of myocardial infarction and acute coronary syndromes, bundle branch blocks, left ventricular hypertrophy, intraventricular conduction delays, significant valvular heart diseases, and permanent pacemakers. The patients were divided into 2 groups based on their ECG: patients with a positive TV1 and those with a negative or flat TV1.
 
Results: Out of 500 patients, 139 (27.8%) had a positive TV1. Multivessel CAD was more frequent in the patients with a positive TV1 than in those with a negative or flat TV1 (40.3% vs 28.5%; P=0.012). The 1-year mortality rate was significantly higher in the patients with a positive TV1 (9.4% vs 2.8%; P=0.003). A positive TV1 was an independent predictor of 1-year mortality (OR, 4.07; 95% CI, 2.16 to 7.62; P<0.001).
 
Conclusions: The findings of the present study suggest that a positive TV1 in patients with normal ECGs and suspected CAD is associated with advanced CAD and is an independent predictor of 1-year mortality. (Iranian Heart Journal 2023; 24(1): 6-14)
Keywords
T wave
Lead V1
Coronary artery disease
Mortality
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Iranian Heart Journal
Volume 24, Issue 1
Winter 2023
Pages 6-14