T-wave amplitude attenuation/augmentation in patients with changing edematous states: implications for patients with congestive heart failure.

Since peripheral edema impacts the entire electrocardiographic curve, it was hypothesized that it would also affect T waves. The amplitude of T waves were measured in all electrocardiographic leads and a sum (SigmaT) was calculated in 28 patients with and 28 patients without peripheral edema (controls). For patients with peripheral edema, SigmaT on admission was 21.9+/-10.6 mm and SigmaT at peak weight was 8.3+/-6.3 mm (P=.0005). For patients with peripheral edema who subsequently lost weight, SigmaT at peak weight was 7.2+/-6.1 mm and SigmaT at the lowest weight was 14.1+/-12.2 (P=.006). For controls, SigmaT from admission and SigmaT from discharge were 24.4+/-16.9 mm and 24.7+/-15.7 mm (P=.82), respectively. Percent change (Delta%SigmaT) from admission to peak weight correlated with Delta% in weight (r=0.58; P=.001) and Delta% in the sum of QRS complexes (SigmaQRS) (r=0.71; P=.00005). Delta%SigmaT from peak weight to the lowest weight correlated with the corresponding Delta%SigmaQRS (r=0.65; P=.02). Changes in T waves with development and alleviation of peripheral edema mirror the changes shown by the QRS complexes and may be useful in the treatment of patients with congestive heart failure or other edematous states.