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The prognostic value of positive T wave in lead aVR: A novel marker of adverse cardiac outcomes in peripartum cardiomyopathy

Annals of Noninvasive Electrocardiology Jan 22, 2019

Ekizler FA, et al. - In 82 patients (mean age 29.1 ± 6.3 years) diagnosed with peripartum cardiomyopathy (PPCM), researchers assessed the prevalence and prognostic role of positive T waves in lead aVR (TaVR). They focused on composite cardiac events, including cardiac death, arrhythmic events, or persistent left ventricular systolic dysfunction (primary endpoint). Presence of a positive TaVR was determined via presentation electrocardiogram (ECG). Higher rates for persistent left ventricular systolic dysfunction, arrhythmic events, and cardiac death were observed in patients with positive T wave in lead aVR vs those without it. Primary composite endpoint was independently and strongly predicted by the presence of positive TaVR in multivariate logistic regression analysis, after adjusting for other confounding factors. With a sensitivity of 100% and specificity of 100%, primary endpoint was predicted by T-wave amplitude in lead aVR, using the cut-off level of 0.25 mV. Overall, positive T wave in lead aVR, as a simple and feasible electrocardiographic marker, appeared to be a new predictor of adverse cardiovascular outcomes in patients with PPCM.

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