The Relationship between the T Wave Amplitude in Lead aVR and the Degree of Left Ventricular Systolic Dysfunction in Patients with Ischemic Cardiomyopathy

Introduction: Acute myocardial infarction remains a leading cause of morbidity and mortality, with impaired myocardial reperfusion and electrical instability playing key roles in adverse outcomes. Atrial conduction abnormalities may reflect ischemic burden and microvascular dysfunction. This study aimed to evaluate the clinical and prognostic significance of atrial electrical indices in relation to reperfusion quality and coronary disease severity.

Material and methods: This retrospective cross‑sectional study included 315 consecutive patients admitted to Shahid Madani Hospital, Tabriz, between March 2023 and March 2024. Clinical, laboratory, electrocardiographic, and angiographic data were extracted from medical records. Standardized ECG measurements, angiographic assessment, and post‑PCI outcomes were analyzed to evaluate electrophysiological and clinical associations.

Results: Among 315 cardiomyopathy patients, ischemic etiology was associated with a significantly higher prevalence of isoelectric T waves in lead aVR compared with non‑ischemic cardiomyopathy (P=0.004 and P=0.030). Other T‑wave amplitude categories showed no significant differences between etiologic groups, nor any significant association with the severity of left ventricular systolic dysfunction (all P>0.05).

Conclusion: This study demonstrates that while traditional cardiovascular risk factors are highly prevalent in patients with cardiomyopathy, T‑wave amplitude in lead aVR provides limited functional insight into left ventricular systolic impairment.