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Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction

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Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction. / Koechlin, Luca; Strebel, Ivo; Zimmermann, Tobias; Nestelberger, Thomas; Walter, Joan; Lopez-Ayala, Pedro; Boeddinghaus, Jasper; Shrestha, Samyut; Arslani, Ketina; Stefanelli, Sabrina; Reuthebuch, Benedikt; Wussler, Desiree; Ratmann, Paul David; Christ, Michael; Badertscher, Patrick; Wildi, Karin; Giménez, Maria Rubini; Gualandro, Danielle M; Miró, Òscar; Fuenzalida, Carolina; Martin-Sanchez, F Javier; Kawecki, Damian; Bürgler, Franz; Keller, Dagmar I; Abächerli, Roger; Reuthebuch, Oliver; Eckstein, Friedrich S; Twerenbold, Raphael; Reichlin, Tobias; Mueller, Christian; APACE Investigators.

in: ANN EMERG MED, Jahrgang 82, Nr. 2, 08.2023, S. 194-202.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Koechlin, L, Strebel, I, Zimmermann, T, Nestelberger, T, Walter, J, Lopez-Ayala, P, Boeddinghaus, J, Shrestha, S, Arslani, K, Stefanelli, S, Reuthebuch, B, Wussler, D, Ratmann, PD, Christ, M, Badertscher, P, Wildi, K, Giménez, MR, Gualandro, DM, Miró, Ò, Fuenzalida, C, Martin-Sanchez, FJ, Kawecki, D, Bürgler, F, Keller, DI, Abächerli, R, Reuthebuch, O, Eckstein, FS, Twerenbold, R, Reichlin, T, Mueller, C & APACE Investigators 2023, 'Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction', ANN EMERG MED, Jg. 82, Nr. 2, S. 194-202. https://doi.org/10.1016/j.annemergmed.2022.12.003

APA

Koechlin, L., Strebel, I., Zimmermann, T., Nestelberger, T., Walter, J., Lopez-Ayala, P., Boeddinghaus, J., Shrestha, S., Arslani, K., Stefanelli, S., Reuthebuch, B., Wussler, D., Ratmann, P. D., Christ, M., Badertscher, P., Wildi, K., Giménez, M. R., Gualandro, D. M., Miró, Ò., ... APACE Investigators (2023). Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction. ANN EMERG MED, 82(2), 194-202. https://doi.org/10.1016/j.annemergmed.2022.12.003

Vancouver

Koechlin L, Strebel I, Zimmermann T, Nestelberger T, Walter J, Lopez-Ayala P et al. Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction. ANN EMERG MED. 2023 Aug;82(2):194-202. https://doi.org/10.1016/j.annemergmed.2022.12.003

Bibtex

@article{579e535359ac48a78f6bd245c4980ad6,
title = "Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction",
abstract = "STUDY OBJECTIVE: The diagnostic performance of T-wave amplitudes for the detection of myocardial infarction is largely unknown. We aimed to address this knowledge gap.METHODS: T-wave amplitudes were automatically measured in 12-lead ECGs of patients presenting with acute chest discomfort to the emergency department within a prospective diagnostic multicenter study. The final diagnosis was centrally adjudicated by 2 independent cardiologists. Patients with left ventricular hypertrophy, complete left bundle branch block, or paced ventricular depolarization were excluded. The performance for lead-specific 95th-percentile thresholds were reported as likelihood ratios (lr), specificity, and sensitivity.RESULTS: Myocardial infarction was the final diagnosis in 445 (18%) of 2457 patients. In most leads, T-wave amplitudes tended to be greater in patients without myocardial infarction than those with myocardial infarction, and T-wave amplitude exceeding the 95th percentile had positive and negative lr close to 1 or with confidence intervals (CIs) crossing 1. The exceptions were leads III, aVR, and V1, which had positive lrs of 3.8 (95% CI, 2.7 to 5.3), 4.3 (95% CI, 3.1 to 6.0) and 2.0 (95% CI, 1.4 to 2.9), respectively. These leads normally have inverted T waves, so T-wave amplitude exceeding the 95th percentile reflects upright rather than increased-amplitude hyperacute T waves.CONCLUSION: Hyperacute T waves, when defined as increased T-wave amplitude exceeding the 95th percentile, did not provide useful information in diagnosing myocardial infarction in this sample.",
keywords = "Humans, Prospective Studies, Sensitivity and Specificity, Myocardial Infarction/diagnosis, Arrhythmias, Cardiac, Electrocardiography, Early Diagnosis",
author = "Luca Koechlin and Ivo Strebel and Tobias Zimmermann and Thomas Nestelberger and Joan Walter and Pedro Lopez-Ayala and Jasper Boeddinghaus and Samyut Shrestha and Ketina Arslani and Sabrina Stefanelli and Benedikt Reuthebuch and Desiree Wussler and Ratmann, {Paul David} and Michael Christ and Patrick Badertscher and Karin Wildi and Gim{\'e}nez, {Maria Rubini} and Gualandro, {Danielle M} and {\`O}scar Mir{\'o} and Carolina Fuenzalida and Martin-Sanchez, {F Javier} and Damian Kawecki and Franz B{\"u}rgler and Keller, {Dagmar I} and Roger Ab{\"a}cherli and Oliver Reuthebuch and Eckstein, {Friedrich S} and Raphael Twerenbold and Tobias Reichlin and Christian Mueller and {APACE Investigators}",
note = "Copyright {\textcopyright} 2022 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.",
year = "2023",
month = aug,
doi = "10.1016/j.annemergmed.2022.12.003",
language = "English",
volume = "82",
pages = "194--202",
journal = "ANN EMERG MED",
issn = "0196-0644",
publisher = "Mosby Inc.",
number = "2",

}

RIS

TY - JOUR

T1 - Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction

AU - Koechlin, Luca

AU - Strebel, Ivo

AU - Zimmermann, Tobias

AU - Nestelberger, Thomas

AU - Walter, Joan

AU - Lopez-Ayala, Pedro

AU - Boeddinghaus, Jasper

AU - Shrestha, Samyut

AU - Arslani, Ketina

AU - Stefanelli, Sabrina

AU - Reuthebuch, Benedikt

AU - Wussler, Desiree

AU - Ratmann, Paul David

AU - Christ, Michael

AU - Badertscher, Patrick

AU - Wildi, Karin

AU - Giménez, Maria Rubini

AU - Gualandro, Danielle M

AU - Miró, Òscar

AU - Fuenzalida, Carolina

AU - Martin-Sanchez, F Javier

AU - Kawecki, Damian

AU - Bürgler, Franz

AU - Keller, Dagmar I

AU - Abächerli, Roger

AU - Reuthebuch, Oliver

AU - Eckstein, Friedrich S

AU - Twerenbold, Raphael

AU - Reichlin, Tobias

AU - Mueller, Christian

AU - APACE Investigators

N1 - Copyright © 2022 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

PY - 2023/8

Y1 - 2023/8

N2 - STUDY OBJECTIVE: The diagnostic performance of T-wave amplitudes for the detection of myocardial infarction is largely unknown. We aimed to address this knowledge gap.METHODS: T-wave amplitudes were automatically measured in 12-lead ECGs of patients presenting with acute chest discomfort to the emergency department within a prospective diagnostic multicenter study. The final diagnosis was centrally adjudicated by 2 independent cardiologists. Patients with left ventricular hypertrophy, complete left bundle branch block, or paced ventricular depolarization were excluded. The performance for lead-specific 95th-percentile thresholds were reported as likelihood ratios (lr), specificity, and sensitivity.RESULTS: Myocardial infarction was the final diagnosis in 445 (18%) of 2457 patients. In most leads, T-wave amplitudes tended to be greater in patients without myocardial infarction than those with myocardial infarction, and T-wave amplitude exceeding the 95th percentile had positive and negative lr close to 1 or with confidence intervals (CIs) crossing 1. The exceptions were leads III, aVR, and V1, which had positive lrs of 3.8 (95% CI, 2.7 to 5.3), 4.3 (95% CI, 3.1 to 6.0) and 2.0 (95% CI, 1.4 to 2.9), respectively. These leads normally have inverted T waves, so T-wave amplitude exceeding the 95th percentile reflects upright rather than increased-amplitude hyperacute T waves.CONCLUSION: Hyperacute T waves, when defined as increased T-wave amplitude exceeding the 95th percentile, did not provide useful information in diagnosing myocardial infarction in this sample.

AB - STUDY OBJECTIVE: The diagnostic performance of T-wave amplitudes for the detection of myocardial infarction is largely unknown. We aimed to address this knowledge gap.METHODS: T-wave amplitudes were automatically measured in 12-lead ECGs of patients presenting with acute chest discomfort to the emergency department within a prospective diagnostic multicenter study. The final diagnosis was centrally adjudicated by 2 independent cardiologists. Patients with left ventricular hypertrophy, complete left bundle branch block, or paced ventricular depolarization were excluded. The performance for lead-specific 95th-percentile thresholds were reported as likelihood ratios (lr), specificity, and sensitivity.RESULTS: Myocardial infarction was the final diagnosis in 445 (18%) of 2457 patients. In most leads, T-wave amplitudes tended to be greater in patients without myocardial infarction than those with myocardial infarction, and T-wave amplitude exceeding the 95th percentile had positive and negative lr close to 1 or with confidence intervals (CIs) crossing 1. The exceptions were leads III, aVR, and V1, which had positive lrs of 3.8 (95% CI, 2.7 to 5.3), 4.3 (95% CI, 3.1 to 6.0) and 2.0 (95% CI, 1.4 to 2.9), respectively. These leads normally have inverted T waves, so T-wave amplitude exceeding the 95th percentile reflects upright rather than increased-amplitude hyperacute T waves.CONCLUSION: Hyperacute T waves, when defined as increased T-wave amplitude exceeding the 95th percentile, did not provide useful information in diagnosing myocardial infarction in this sample.

KW - Humans

KW - Prospective Studies

KW - Sensitivity and Specificity

KW - Myocardial Infarction/diagnosis

KW - Arrhythmias, Cardiac

KW - Electrocardiography

KW - Early Diagnosis

U2 - 10.1016/j.annemergmed.2022.12.003

DO - 10.1016/j.annemergmed.2022.12.003

M3 - SCORING: Journal article

C2 - 36774205

VL - 82

SP - 194

EP - 202

JO - ANN EMERG MED

JF - ANN EMERG MED

SN - 0196-0644

IS - 2

ER -