Jones M E, Short D S
Scott Med J. 1983 Apr;28(2):124-31. doi: 10.1177/003693308302800206.
T wave inversion confined to the lateral leads presents one of the commonest dilemmas in the field of electrocardiogram (ECG) reporting. The differentiation between lateral ischaemia and left ventricular hypertrophy is generally based on the presence or absence of the accepted voltage criterion of hypertrophy, even though this is admitted to have a relatively low degree of sensitivity. In this study the repolarisation pattern in V6 has been analysed in a consecutive series of 100 patients showing T inversion of at least 1 mm in this lead, and correlated with the diagnosis. Patients on digoxin or similar drugs were excluded. Thirty-four patients were diagnosed as having hypertension or aortic valve disease or a combination of the two conditions: 31 as pure ischaemic heart disease; 24 as a combination of ischaemic and hypertensive or aortic valvular disease and 11 as having miscellaneous diseases. Two abnormalities of the T wave showed a significant association with aortic valve disease and hypertension; namely marked asymmetry and terminal positivity (overshoot). These features were sometimes seen in these diseases when the commonly acceptable voltage criterion of left ventricular hypertrophy was lacking.
局限于侧壁导联的T波倒置是心电图（ECG）报告领域最常见的难题之一。尽管公认肥厚的电压标准敏感性相对较低，但侧壁心肌缺血与左心室肥厚的鉴别通常基于该标准的有无。在本研究中，对连续100例V6导联T波倒置至少1mm的患者的复极模式进行了分析，并与诊断结果相关联。排除了使用地高辛或类似药物的患者。34例患者被诊断为患有高血压或主动脉瓣疾病或两者合并；31例为单纯缺血性心脏病；24例为缺血性与高血压或主动脉瓣疾病合并；11例患有其他杂病。T波的两种异常与主动脉瓣疾病和高血压有显著关联，即明显不对称和终末正向（超射）。当缺乏左心室肥厚通常可接受的电压标准时，这些特征有时在这些疾病中可见。
