PURPOSE: The aim of this study was to clarify the significance of a Q wave in lead negative aVR (-aVR) in anterior wall acute myocardial infarction (AMI). METHODS: Eighty-seven patients with a first anterior wall AMI were classified into 2 groups according to the presence (n = 17, group A) or absence (n = 70, group B) of a prominent Q wave (duration > or =20 milliseconds) in lead -aVR at predischarge. Group A had a higher prevalence of a long left anterior descending coronary artery (LAD), a lower left ventricular ejection fraction, and more reduced regional wall motion in the apical and inferior regions than group B. None of group A patients had an LAD that did not reach the apex. CONCLUSION: A prominent Q wave in lead -aVR in anterior wall AMI is related to severe regional wall motion abnormality in the apical and inferior regions, with an LAD wrapping around the apex. Copyright (c) 2010 Elsevier Inc. All rights reserved.
PURPOSE: The aim of this study was to clarify the significance of a Q wave in lead negative aVR (-aVR) in anterior wall acute myocardial infarction (AMI). METHODS: Eighty-seven patients with a first anterior wall AMI were classified into 2 groups according to the presence (n = 17, group A) or absence (n = 70, group B) of a prominent Q wave (duration > or =20 milliseconds) in lead -aVR at predischarge. Group A had a higher prevalence of a long left anterior descending coronary artery (LAD), a lower left ventricular ejection fraction, and more reduced regional wall motion in the apical and inferior regions than group B. None of group A patients had an LAD that did not reach the apex. CONCLUSION: A prominent Q wave in lead -aVR in anterior wall AMI is related to severe regional wall motion abnormality in the apical and inferior regions, with an LAD wrapping around the apex. Copyright (c) 2010 Elsevier Inc. All rights reserved.