BACKGROUND: The present study evaluates the lack of Q waves on the electrocardiogram (ECG) in the prediction of myocardial viability compared with dobutamine stress echocardiography (DSE) and rest-redistribution thallium-201 (Tl-201) scintigraphy. HYPOTHESIS: The lack of pathologic Q waves (NoQ) may be a readily available and specific marker for the presence of viability. METHODS: Sixty four patients with stable coronary artery disease (CAD) and ventricular dysfunction underwent rest ECG, DSE, and Tl-201 scintigraphy before revascularization, and a repeat rest 2-Dimensional (2-D) echocardiogram more than 3 mo later. RESULTS: Total viability at baseline (% of total segments) was higher in the NoQ group by Tl-201 scintigraphy (87 +/- 19% versus 70 +/- 20%, p = 0.008) and by DSE (81 +/- 20% versus 65 +/- 24%, p = 0.013). As expected, the sensitivity of NoQ waves was low in predicting recovery of function (23%), and inferior to Tl-201 (82%) and DSE (84%) (p<0.08). However, specificity of NoQ waves for predicting recovery of global function was high (72%); higher than Tl-201 (50%) and DSE (45%). Positive predictive values were comparable among all modalities. Results were similar if the data were analyzed regionally for viability. CONCLUSION: Lack of pathologic Q waves is a specific and readily available marker of myocardial viability in patients with chronic CAD, which should alert the clinician for myocardial hibernation.
BACKGROUND: The present study evaluates the lack of Q waves on the electrocardiogram (ECG) in the prediction of myocardial viability compared with dobutamine stress echocardiography (DSE) and rest-redistribution thallium-201 (Tl-201) scintigraphy. HYPOTHESIS: The lack of pathologic Q waves (NoQ) may be a readily available and specific marker for the presence of viability. METHODS: Sixty four patients with stable coronary artery disease (CAD) and ventricular dysfunction underwent rest ECG, DSE, and Tl-201 scintigraphy before revascularization, and a repeat rest 2-Dimensional (2-D) echocardiogram more than 3 mo later. RESULTS: Total viability at baseline (% of total segments) was higher in the NoQ group by Tl-201 scintigraphy (87 +/- 19% versus 70 +/- 20%, p = 0.008) and by DSE (81 +/- 20% versus 65 +/- 24%, p = 0.013). As expected, the sensitivity of NoQ waves was low in predicting recovery of function (23%), and inferior to Tl-201 (82%) and DSE (84%) (p<0.08). However, specificity of NoQ waves for predicting recovery of global function was high (72%); higher than Tl-201 (50%) and DSE (45%). Positive predictive values were comparable among all modalities. Results were similar if the data were analyzed regionally for viability. CONCLUSION: Lack of pathologic Q waves is a specific and readily available marker of myocardial viability in patients with chronic CAD, which should alert the clinician for myocardial hibernation.
Authors: M A Quinones; A D Waggoner; L A Reduto; J G Nelson; J B Young; W L Winters; L G Ribeiro; R R Miller Journal: Circulation Date: 1981-10 Impact factor: 29.690
Authors: Arend F l Schinkel; Jeroen J Bax; Eric Boersma; Abdou Elhendy; Eleni C Vourvouri; Jos R T C Roelandt; Don Poldermans Journal: Am Heart J Date: 2002-11 Impact factor: 4.749
Authors: G S Wagner; C J Freye; S T Palmeri; S F Roark; N C Stack; R E Ideker; F E Harrell; R H Selvester Journal: Circulation Date: 1982-02 Impact factor: 29.690