Pulmonary Artery Wedge Pressure, Left Atrial Dimension, and PTF-V1 in Patients with Acute Myocardial Infarction

pressure or volume overload in patients with valvular heart disease.' Abnormalities in the terminal portion of the P wave in lead V, were also reported in separate studies in patients with pulmonary edema2 and in patients with acute myocardial infarction presenting with clinical and radiographic evidence of congestive heart failure.3 4 These electrocardiographic abnormalities tended to regress with clinical improvement, suggesting that an abnormal terminal negativity of the P wave in lead V, was the result of left atrial hypertension.3, 4 In a more recent study of patients with acute myocardial infarction, a direct correlation was found between the mean left atrial (LAm) pressure, as estimated by the pulmonary artery end-diastolic (PAEDP) or mean pulmonary artery wedge pressure (PAWP) and the P wave terminal force in V, (PTF-V,) in the standard 12-lead electrocardiogram.5 In this study, an abnormal PTF-V,, defined as greater than -0.03