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T wave normalization in infarct-related electrocardiographic leads during exercise testing for detection of residual viability

comparison with positron emission tomography

^a Cardiology Unit, Carretta Hospital, Montebelluna, Italy
^* Nuclear Medicine Department–PET Center and Cardiology Unit, San Giacomo Hospital, Castelfranco Veneto, Italy

View larger version (42K): [in a new window]   Figure 1 Sensitivity (sens.), specificity (spec.) and diagnostic accuracy (acc.) of exercise-induced TWN at every work load (open bars) and at a work load 50 W (hatched bars) for predicting viability for all patients (open and hatched bars) and for patients with an anterior infarction at a work load 50 W (solid bars).

View larger version (143K): [in a new window]   Figure 2 Left, Precordial leads of rest ECG in a group 1a patient. Right, Exercise ECG. The rest negative T waves on the IRLs became positive at a work load of 50 W.

View larger version (61K): [in a new window]   Figure 3 Same patient as in Figure 2. Top, Perfusion PET study by N-13 ammonia (NH3), left ventricle, long- and short-axis views; N-13 ammonia uptake is present and is homogeneous in the entire myocardial wall, with only a slight reduction in the apex. Bottom, Metabolism PET study by F-18 FDG. F-18 FDG uptake is reduced but is still present in the apex and septum, showing residual viability.