[Clinical significance of prominent negative T waves induced by exercise test].

The significance of deep T wave inversion during and after exercise in patients with coronary artery disease has not been studied well. Using the treadmill exercise test (modified Bruce's protocol) and coronary arteriography, we evaluated 361 patients suspected of having coronary artery disease. Results were compared for patients who developed significant T wave inversions of greater than 8 mm (prominent negative T wave: PNT) and for patients who had significant down-sloping ST depressions (DS). Sixteen patients had PNT (4%) which became maximum three to five min after exercise, and ranged in depth from 8 to 15 mm (10.9 +/- 2.4 mm). There were 83 patients with DS (23%). Exercise duration was 3.3 +/- 1.4 min in the PNT group and 4.4 +/- 1.9 min in the DS group (p less than 0.01). Prevalence of three-vessel disease or left main trunk disease was 88% (14 patients) in the PNT group, 28% in the DS group, and 19% (70 patients) in the entire 361 patients. Among the 14 patients who had three-vessel disease or left main trunk disease in the PNT group, the degree of multiple stenoses exceeded 90% in the major coronary arteries and that of the left main trunk stenosis exceeded 75%. The two remaining patients included one with two-vessel disease and severe 99% narrowing of the major coronary arteries and one patient having one-vessel disease with vasospastic angina during exercise. Prevalence of coronary revascularization was 69% in the PNT group and 36% in the DS group (p less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)