Distribution Features of Microvolt T-wave Alternation in Coronary Artery Disease Patients With MTWA Changes After Revascularization / 中国循环杂志

ABSTRACT

Objective: To explore the distribution features of microvolt T-wave alternation(MTWA) through exercise stress test (EST) in coronary artery disease (CAD) patients with MTWA changes after revascularization. Methods: MTWA was measured in pre-cordial ECG leads in 326 patients with suspected CAD. Based on coronary angiography and coronary CTA, the patients were divided into 4 groups ① Control group, patients without coronary stenosis, n=101, ② Coronary stenosis<50％ group, n=99, ③ 50％ ≤ Coronary stenosis<70％ group, n=53 and ④ Coronary stenosis ≥ 70％ group, n=73; MTWA was compared among different groups. 95 patients with coronary stenosis ≥ 50％were further divided into 2 subgroups R (right coronary)stenosis ≥ 50％ subgroup, n=23 and LAD (left anterior descending branch) stenosis ≥ 50％ subgroup, n=72; MTWA was respectively compared to Control group. In addition, MTWA was collected from 103 patients with percutaneous coronary intervention (PCI) as PCI group, MTWA was compared to Coronary stenosis ≥ 70％ group. Results: MTWA was obviously higher in Coronary stenosis ≥ 70％ group than the other 3 groups, all P<0.01. Compared with Control group, Rstenosis ≥ 50％ subgroup had increased MTWA in V4-V6 pre-cordial leads, P<0.05; LAD stenosis≥50％ subgroup had increased MTWA in V1-V2 pre-cordial leads, P<0.01. Compared with Coronary stenosis ≥ 70％group, PCI group showed reduced MTWA, P<0.01. Conclusion: CAD patients with severe coronary stenosis (≥70％) had increased MTWA; MTWA distribution in body surface was approximately corresponding to coronary stenosis site and PCI may decrease MTWA in CAD patients.