BACKGROUND: An abnormal Q wave is usually defined as an initial depression of the QRS complex having a duration of > or =40 ms and amplitude exceeding 25% of the following R wave in any contiguous leads on the 12-lead electrocardiogram (ECG). However, much smaller Q waves are sometimes recorded on the ECG. This study investigated the diagnostic value of the small Q wave recorded in precordial leads V(2) or V(3) on the ECG. METHODS: We investigated 807 consecutive patients who underwent coronary angiography. A small Q wave was defined as any negative deflection preceding the R wave in V(2) or V(3) with <40-ms duration and <0.5-mV amplitude, with or without a small (<0.1-mV) slurred, spiky fragmented initial QRS deflection before the Q wave (early fragmentation). ECG and coronary angiographic findings were analyzed. RESULTS: The small Q wave was present in 87 patients. Multiple logistic regression analysis revealed that presence of a small Q wave was a strong independent predictor of any coronary artery stenosis or left anterior descending artery (LAD) stenosis (odds ratio = 2.706, 2.902; P < 0.001, < 0.001, respectively). CONCLUSION: A small Q wave (<40-ms duration and <0.5-mV amplitude) in V(2) or V(3) with or without early fragmentation significantly predicted the presence of CAD and, especially, significant stenosis in the LAD.
BACKGROUND: An abnormal Q wave is usually defined as an initial depression of the QRS complex having a duration of > or =40 ms and amplitude exceeding 25% of the following R wave in any contiguous leads on the 12-lead electrocardiogram (ECG). However, much smaller Q waves are sometimes recorded on the ECG. This study investigated the diagnostic value of the small Q wave recorded in precordial leads V(2) or V(3) on the ECG. METHODS: We investigated 807 consecutive patients who underwent coronary angiography. A small Q wave was defined as any negative deflection preceding the R wave in V(2) or V(3) with <40-ms duration and <0.5-mV amplitude, with or without a small (<0.1-mV) slurred, spiky fragmented initial QRS deflection before the Q wave (early fragmentation). ECG and coronary angiographic findings were analyzed. RESULTS: The small Q wave was present in 87 patients. Multiple logistic regression analysis revealed that presence of a small Q wave was a strong independent predictor of any coronary artery stenosis or left anterior descending artery (LAD) stenosis (odds ratio = 2.706, 2.902; P < 0.001, < 0.001, respectively). CONCLUSION: A small Q wave (<40-ms duration and <0.5-mV amplitude) in V(2) or V(3) with or without early fragmentation significantly predicted the presence of CAD and, especially, significant stenosis in the LAD.
Authors: Kristian Thygesen; Joseph S Alpert; Harvey D White; Allan S Jaffe; Fred S Apple; Marcello Galvani; Hugo A Katus; L Kristin Newby; Jan Ravkilde; Bernard Chaitman; Peter M Clemmensen; Mikael Dellborg; Hanoch Hod; Pekka Porela; Richard Underwood; Jeroen J Bax; George A Beller; Robert Bonow; Ernst E Van der Wall; Jean-Pierre Bassand; William Wijns; T Bruce Ferguson; Philippe G Steg; Barry F Uretsky; David O Williams; Paul W Armstrong; Elliott M Antman; Keith A Fox; Christian W Hamm; E Magnus Ohman; Maarten L Simoons; Philip A Poole-Wilson; Enrique P Gurfinkel; José-Luis Lopez-Sendon; Prem Pais; Shanti Mendis; Jun-Ren Zhu; Lars C Wallentin; Francisco Fernández-Avilés; Kim M Fox; Alexander N Parkhomenko; Silvia G Priori; Michal Tendera; Liisa-Maria Voipio-Pulkki; Alec Vahanian; A John Camm; Raffaele De Caterina; Veronica Dean; Kenneth Dickstein; Gerasimos Filippatos; Christian Funck-Brentano; Irene Hellemans; Steen Dalby Kristensen; Keith McGregor; Udo Sechtem; Sigmund Silber; Michal Tendera; Petr Widimsky; José Luis Zamorano; Joao Morais; Sorin Brener; Robert Harrington; David Morrow; Michael Lim; Marco A Martinez-Rios; Steve Steinhubl; Glen N Levine; W Brian Gibler; David Goff; Marco Tubaro; Darek Dudek; Nawwar Al-Attar Journal: Circulation Date: 2007-10-19 Impact factor: 29.690
Authors: S Coll; A Betriu; T de Flores; E Roig; G Sanz; L Mont; J Magriñá; A Serra; F Navarro López Journal: Am J Cardiol Date: 1988-04-01 Impact factor: 2.778
Authors: John H Alexander; Robert A Harrington; Manju Bhapkar; Kenneth W Mahaffey; A Michael Lincoff; E Magnus Ohman; Peter Klootwijk; Olle Pahlm; Bo Henden; Jaap W Deckers; Maarten L Simoons; Robert M Califf; Galen S Wagner Journal: Am J Med Date: 2003-12-01 Impact factor: 4.965
Authors: Alexander Steger; Daniel Sinnecker; Anna Berkefeld; Alexander Müller; Josef Gebhardt; Michael Dommasch; Katharina M Huster; Petra Barthel; Georg Schmidt Journal: Herzschrittmacherther Elektrophysiol Date: 2015-09