Significance of Q wave disappearance in the chronic phase following transmural acute myocardial infarction.

Yasuda, Mitsutaka; Iida, Hidetaka; Itagane, Hiroshi; Tahara, Akira; Toda, Iku; Akioka, Kaname; Teragaki, Masakazu; Oku, Hisao; Takeuchi, Kazuhide; Takeda, Tadanao; Yamagishi, Hiroyuki; Naruko, Takahiko; Ikuno, Yoshiyasu

doi:10.1253/jcj.54.12_1517

Cited by 19 publications

(15 citation statements)

References 19 publications

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“…1 However, the Q wave may regress or even disappear over time in as many as 25% to 63% of patients with a history of a Q-wave MI by ECG. 2,3 The overall sensitivity of a Q wave for prior MI is limited by the ECG and is as low as 25% for a lateral MI. 4,5 This situation is probably due to recent improvements in the management of acute MI, including aggressive medical therapy, the use of thrombolytic agents, and early coronary revascularization.…”

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confidence: 99%

Significance of a Fragmented QRS Complex Versus a Q Wave in Patients With Coronary Artery Disease

et al. 2006

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Background-Q waves on a 12-lead ECG are markers of a prior myocardial infarction (MI). However, they may regress or even disappear over time, and there is no specific ECG sign of a non-Q-wave MI. Fragmented QRS complexes (fQRSs), which include various RSRЈ patterns, without a typical bundle-branch block are markers of altered ventricular depolarization owing to a prior myocardial scar. We postulated that the presence of an fQRS might improve the ability to detect a prior MI compared with Q waves alone by ECG. Methods and Results-A cohort of 479 consecutive patients (meanϮSD age, 58.2Ϯ13.2 years; 283 males) who were referred for nuclear stress tests was studied. The fQRS included various morphologies of the QRS (Ͻ120 ms), which included an additional R wave (RЈ) or notching in the nadir of the S wave, or Ͼ1 RЈ (fragmentation) in 2 contiguous leads, corresponding to a major coronary artery territory. The Q wave was present in 71 (14.8%) patients, an fQRS was present in 191 (34.9%) patients, and an fQRS and/or a Q wave was present in 203 (42.3%) patients. Sensitivity, specificity, and the negative predictive value for myocardial scar as detected by single photon emission computed tomography analysis were 36.3%, 99.2%, and 70.8%, respectively, for the Q wave alone; 85.6%, 89%, and 92.7%, respectively, for the fQRS; and 91.4%, 89%, and 94.2%, respectively, for the Q wave and/or fQRS. Conclusions-The fQRS on a 12-lead ECG is a marker of a prior MI, defined by regional perfusion abnormalities, which has a substantially higher sensitivity and negative predictive value compared with the Q wave.

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confidence: 99%

Significance of a Fragmented QRS Complex Versus a Q Wave in Patients With Coronary Artery Disease

et al. 2006

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“…Several studies [2, 4, 6, 7, 9] reported that patients with RWR had a smaller infarct size and better left ventricular function whereas Iwasaki et al [5] showed no such association. The CMR in case 1 showed a smaller infarct size and peri-infarct border zone as compared with case 2.…”

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confidence: 99%

“…Not infrequently, very early loss of R waves may be visible in patients presenting with anterior STEMI and occasionally, these R waves reappear in the first months following the index event. Despite reports in the literature [1–9], the prognostic significance of R-wave reappearance (RWR) in the setting of primary percutaneous coronary intervention (pPCI) remains uncertain. In this report we present two patients with anterior STEMI who underwent uncomplicated pPCI.…”

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confidence: 99%

Precordial R-wave reappearance predicting infarct size and myocardial recovery after acute STEMI

2011

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“…Partial or complete disappearance of abnormal Q waves has been shown to reflect the electrical and functional recovery of the viable myocardium in the infarct area [1, 2, 3, 4, 5]. However, in the clinical setting, improvement in left ventricular (LV) wall motion in the infarct region is often observed in the healing stage of acute MI even in patients with persistent abnormal Q waves.…”

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confidence: 99%

Spontaneous Normalization of Negative T Waves in Infarct-Related Leads Reflects Improvement in Left Ventricular Wall Motion even in Patients with Persistent Abnormal Q Waves after Anterior Wall Acute Myocardial Infarction

Nagase

Tamura²,

Mikuriya³

et al. 2001

Cardiology

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This study aimed to clarify whether spontaneous T-wave normalization (TWN) in infarct-related leads reflects improvement in left ventricular (LV) wall motion even in patients with persistent abnormal Q waves after acute myocardial infarction (AMI). Eighty-five patients were classified into the following 3 groups: patients with Q-wave regression (group A, n = 21), those with persistent abnormal Q waves and TWN (group B, n = 36), and those with persistent abnormal Q waves and absence of TWN (group C, n = 28). Groups A and B had greater improvement in LV ejection fraction and regional wall motion between 1 and 6 months after AMI than group C. In conclusion, spontaneous TWN in the healing stage of anterior AMI reflects functional recovery of viable myocardium in the infarct region even in patients with persistent abnormal Q waves.

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Significance of Q wave disappearance in the chronic phase following transmural acute myocardial infarction.

Cited by 19 publications

References 19 publications

Significance of a Fragmented QRS Complex Versus a Q Wave in Patients With Coronary Artery Disease

Significance of a Fragmented QRS Complex Versus a Q Wave in Patients With Coronary Artery Disease

Precordial R-wave reappearance predicting infarct size and myocardial recovery after acute STEMI

Spontaneous Normalization of Negative T Waves in Infarct-Related Leads Reflects Improvement in Left Ventricular Wall Motion even in Patients with Persistent Abnormal Q Waves after Anterior Wall Acute Myocardial Infarction

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