Abstract
We studied the clinical significance of repetitive T wave inversion in 38 patients with initial acute anteroseptal infarction (mean age 63.0±12.1 years) who were admitted 24 hours after onset of myocardial infarction (MI) . They were divided into two groups : 19 with repetitive T wave inversion (Group A) and 19 without repetitive T wave inversion (Group B) . Regarding the incidence of preinfarction angina, no significance was found between the two groups, but in Group A new-onset-type unstable angina was higher (p<0.05), and postinfarction angina was also significantly higher (p<0.05) . The early appearance of abnormal Q wave (less than four hours after the onset of MI) was more frequent in Group A (p<0.05) . In Group A, residual stenosis of infarct-related arteries in the acute stage was severe (87.5±20.1 % vs 68.1±29.6 %, p<0.05), the filling delay was greater and the collaterals were lower. In the echocardiographic study, wall thinning in Group A was found to occur earlier (2.7±1.7 days vs 7.1±5.3 days, p<0.01) and left ventricular dilatation in Group A was observed significantly earlier than in Group B. The incidence of the improvement of infarct-site asynergy by echocardiography was frequent in Group A. The exercise duration time in the exercise tolerance test by bicycle ergometer was short in Group A. In conclusion, we suggest that repetitive T wave inversion is due to the different processes of the formation of myocardial infarction, such as the degree of blood flow to the infarcted area in the acute stage, wall thinning, and left ventricular dilatation, which is known as expansion.
