Objective. To determine whether T wave normalization during exercise test can predict viable myocardium in patients with previous anterior wall myocardial infraction.
Design. Prospective, cross sectional design
Setting. Heart Center, Tertiary Institution
Methodology. All patients with previous diagnosis of anterior wall myocardial infarction referred for Thallium Stress from January 2003 up to October 15, 2004 was included in the study. The occurrence of exercise induced T wave normalization in the infarct related leads was correlated with the presence of significant area of viable myocardium detected on imaging study taken at rest, 4 hours and 24 hours.
Results. Among 53 subjects, 36 (67.9%) had exercise induced T wave normalization and 26 (76%) patients showed reversible perfusion defects in the infarcted area while in the remaining 10 (53%) patients fixed defects in the infarcted area were detected during thallium scintigraphy with a sensitivity, specificity, positive and negative predictive value of 76.5%, 47.4%, 72.2%, and 52.9% respectively.
Conclusion. The electrocardiographic variable which was exercise induced T wave normalization is a poor predictor of significant area of ischemic and reversible myocardial segments in patients with previous anterior wall myocardial infarction.