ELECTROCARDIOGRAPHIC POOR R-WAVE PROGRESSION .2. CORRELATION WITH ANGIOGRAPHY

Poor R wave progression (PRWP) or reversed R wave progression (RRWP) on the ECG in 40 patients who underwent coronary arteriography and left ventriculography within 1 mo. of electrocardiographic recording were analyzed. Patients were randomly selected from a population of catheterization proven predominant mitral stenosis with elevated right ventricular pressures (presumed right ventricular hypertrophy), predominant aortic stenosis with increased left ventricular mass (left ventricular hypertrophy) and anterior myocardial infarction (AMI). Application of criteria derived from vectorcardiographic (VCG) correlative data and as inclusion of right precordial lead repolarization abnormalities diagnosed 85% (11/13) of angiographic AMI. In 56% (15/27) of patients with either PRWP or RRWP angiographic AMI could be identified by 12 lead ECG with 12% (2/17) false negative AMI. Q wave anterior myocardial infarctions compared with PRWP or RRWP showed a trend toward a less severe degree of contraction abnormality on contrast ventriculography.