THE NATURAL-HISTORY OF POSTISCHEMIC T-WAVE INVERSION - A PREDICTOR OFPOOR SHORT-TERM PROGNOSIS

Background: This study followed up the natural history of T-wave inver sion and assessed the short-term prognosis associated with the conditi on. Methods: Forty patients with acute ischemic syndrome, without infa rction, and with postischemic T-wave inversion (group 1) were followed during the persistence (inverted T-wave period) and after the resolut ion of T-wave inversion (positive T-wave period). Another 40 patients with acute ischemic syndrome, without infarction and with normal T wav es (group 2), were also followed. Results: Postischemic inverted T wav es showed resolution within 3-21 days of presentation in 31 patients f rom group 1 on medical treatment alone. Further ischemic events (acute myocardial infarction, acute ischemic syndrome, angina pectoris, sile nt ischemia), inducible ischemia (during treadmill test), wall-motion abnormalities (demonstrated by echocardiography), all developing in th e primarily ischemic myocardial area, were more frequent (P<0.02) in g roup 1 patients during the inverted T-wave period compared with those experienced in the positive T-wave period of group 1 patients, and com pared with group 2 patients.Conclusion: In most patients on medical tr eatment, postischemic inverted T-waves tended to resolve within 3 week s. The presence of postischemic inverted T waves appears to be an inde pendent marker of further ischemic events.