Does the presence of Q waves on ECG indicate myocardial scar on cardiac MRI?

Singh, Gurjit; Tzogias, Leonidas; Njeim, Mario; Pantelic, Milan; Nour, Khalid; Al‐Mallah, Mouaz H.

doi:10.1186/1532-429x-11-s1-p265

J Cardiovasc Magn Reson

2009

DOI: 10.1186/1532-429x-11-s1-p265

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Does the presence of Q waves on ECG indicate myocardial scar on cardiac MRI?

Gurjit Singh

Leonidas Tzogias

Mario Njeim

et al.

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2024

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Diagnostic values of inferior Q-waves for myocardial scar identification detected by 3.0 T cardiac MRI

Kosum,

Theerasuwipakorn,

Srisuwanwattana

et al. 2024

Sci Rep

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While Q-waves in inferior leads, particularly lead III, can be regarded as a minor abnormality, it can also indicate the presence of myocardial scar. This study assessed the diagnostic value of pathologic inferior Q-waves (lead II, III, aVF) for detecting ischemic scars using a high-resolution 3.0 T cardiac magnetic resonance (CMR). We retrospectively analyzed 1692 patients with suspected or known coronary artery disease who underwent stress CMR perfusion or viability assessment. Pathologic Q-waves were defined as duration of ≥ 30 ms and depth of ≥ 1 mm or QS-complex. Eleven models were created to evaluate the presence of Q-waves in different combinations of inferior leads. Of the 1692 patients, 436 (25.8%) had pathologic Q-waves. Models with Q-waves in leads II + aVF (model 7) and II + III + aVF (model 9) showed high specificity (100% and 99.6%), positive predictive value (PPV) (80.0% and 86.7%), and negative predictive value (NPV) (82.6% and 84.3%) but low sensitivity (1.3% and 13.1%). Other models also maintained high specificity and NPV but poor sensitivity and PPV. Notably, 21% of patients with an isolated pathologic Q-wave in lead III (model 4) exhibited scars. These findings highlight the need for careful clinical assessment when pathologic Q-waves are present.

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Diagnostic values of inferior Q-waves for myocardial scar identification detected by 3.0 T cardiac MRI

Kosum,

Theerasuwipakorn,

Srisuwanwattana

et al. 2024

Sci Rep

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Does the presence of Q waves on ECG indicate myocardial scar on cardiac MRI?

Cited by 1 publication

References 0 publications

Diagnostic values of inferior Q-waves for myocardial scar identification detected by 3.0 T cardiac MRI

Diagnostic values of inferior Q-waves for myocardial scar identification detected by 3.0 T cardiac MRI

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