TWARMI pilot trial: The value and optimal criteria of microvolt T‐wave alternans in the diagnosis of reversible myocardial ischemia in patients without structural cardiac disease

• DOI: 10.1111/anec.12610
• Publication Date: 2018-11-01T14:58:53Z
• Authors: Mislav Puljevic; Ludmila Danilowic...; Giulio Molon; Davor Puljevic; Grzegorz Raczak; Guido Canali; Vedran Velagic; Borka Pezo‐Nikolic; Davor Milicic
• Keywords: T wave alternans

Abstract Aims Microvolt T‐wave alternans (MTWA) testing is a beat‐to‐beat fluctuation in the amplitude of T wave. We investigated whether: (a) MTWA can be new non‐invasive tool for detection reversible ischemia patients with suspected CAD without structural heart disease, (b) detect earlier and greater test accuracy compared exercise ECG ST‐segment testing, (c) threshold value rate at which estimated different to standard values. Methods A total 101 stable coronary but were included. Echocardiography, test, classical modified values, angiography performed. Results About 33.3% had false‐positive result on test. The sensitivity artery disease was 97.8%, specificity 42.5% (DOR 33.89). In group angiographically positive patients, accurately identified 60% while 40% false‐negative result. 91.8% negative 8.2% false positives. 59.61% 91.83%. Best ratio (86.53% 95.91%, DOR 151.06) criteria (MTWA >1.5 µV 115–125/min). Conclusions This study showed that disease. Also, testing.