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In a few numbers of these patients, the baseline T wave abnormalities may return to normal during ischemia referred to as pseudonormalization of the T wave, the significance of this phenomena is unknown.

The aim of this study to determine if T-wave pseudonormalization during exercise or pharmacological stress testing identified patients with myocardial ischemia as indicated by reversible perfusion defects.

Methods: We retrospectively reviewed the combined exercisepharmacological stress testing records performed in our hospital over 1 year.

Depending on the pattern of change in the T wave morphology the patients were divided into 2 groups, either pseudo normalization or control group ( baseline T wave inversions that persisted after the test).

The results of perfusion scintigraphy were compared in patients with and without stress-induced T-wave normalization.

The categorical data obtained in both the group were analyzed using chi-square test.

Results: A total of 111 consecutive patients who met the inclusion criteria were evaluated in our study.

In control arm, there were a total of 70 subjects with mean age of 53.1 years.

Majority n 41 (58) were male, 31 (44) had diabetes mellitus and 57 (81 ) had hypertension.

The average EF in this group was 53.1.

Meanwhile, in pseudo-normal group, there were a total of 41 subjects.

Mean age was 58.3 years, 22 (53 ) were male, 15 (36) had DM and 31 (75 ) had hypertension The average EF was in these patients was 55.27.

A total of 18 patients (85.7) had reversible ischemia by stress test in this group.

There was no statistically significant difference in baseline characteristics in 2 groups.

Conclusion: In presence of baseline T wave abnormalities pseudonormalization is predictive of reversible perfusion defect.

Pseudonormalization can add to sensitivity and accuracy of stress test for diagnosis of ischemic heart disease.

Pseudo-Normalization T Wave