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The endocardial extent of reperfused first-time myocardial infarction is more predictive of pathologic Q waves than is infarct transmurality: a magnetic resonance imaging study.

Engblom, Henrik LU ; Carlsson, Minna B; Hedström, Erik LU ; Heiberg, Einar LU ; Ugander, Martin LU ; Wagner, Galen S and Arheden, Håkan LU (2007) In Clinical Physiology and Functional Imaging 27(2). p.101-108
Abstract
Historically, Q-wave myocardial infarction (MI) has been equated with transmural MI. This association have, however, recently been rejected. The endocardial extent of MI is another potential determinant of pathological Q waves, since the first part of the QRS complex where the Q wave appears reflects depolarization of subendocardial myocardium. Therefore, the aim of the present study was to test the hypothesis that endocardial extent of MI is more predictive of pathological Q waves than is MI transmurality and to investigate the relationship between QRS scoring of the ECG and MI characteristics. Twenty-nine patients with reperfused first-time MI were prospectively enrolled. One week after admission, delayed contrast-enhanced magnetic... (More)
Historically, Q-wave myocardial infarction (MI) has been equated with transmural MI. This association have, however, recently been rejected. The endocardial extent of MI is another potential determinant of pathological Q waves, since the first part of the QRS complex where the Q wave appears reflects depolarization of subendocardial myocardium. Therefore, the aim of the present study was to test the hypothesis that endocardial extent of MI is more predictive of pathological Q waves than is MI transmurality and to investigate the relationship between QRS scoring of the ECG and MI characteristics. Twenty-nine patients with reperfused first-time MI were prospectively enrolled. One week after admission, delayed contrast-enhanced magnetic resonance imaging (DE-MRI) was performed and 12-lead ECG was recorded. Size, transmurality and endocardial extent of MI were assessed by DE-MRI. Q waves were identified with Minnesota coding and electrocardiographic MI size was estimated by QRS scoring of the ECG. There was a significant difference between patients with and without Q waves with regard to MI size (P = 0.03) and endocardial extent of MI (P = 0.01), but not to mean and maximum MI transmurality (P = 0.09 and P = 0.14). Endocardial extent was the only independent predictor of pathological Q waves. Endocardial extent of MI was most strongly correlated to QRS score (r = 0.86, P < 0.001) of the MI variables tested. The endocardial extent of reperfused first-time acute MI is more predictive of pathological Q waves than is MI transmurality. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Physiology and Functional Imaging
volume
27
issue
2
pages
101 - 108
publisher
Wiley Online Library
external identifiers
  • wos:000244273400003
  • scopus:33847205012
ISSN
1475-0961
DOI
10.1111/j.1475-097X.2007.00723.x
language
English
LU publication?
yes
id
7be51c85-02c3-4917-8ff8-ce32a460d34f (old id 165597)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17309530&dopt=Abstract
date added to LUP
2007-07-23 08:59:38
date last changed
2017-08-27 04:22:18
@article{7be51c85-02c3-4917-8ff8-ce32a460d34f,
  abstract     = {Historically, Q-wave myocardial infarction (MI) has been equated with transmural MI. This association have, however, recently been rejected. The endocardial extent of MI is another potential determinant of pathological Q waves, since the first part of the QRS complex where the Q wave appears reflects depolarization of subendocardial myocardium. Therefore, the aim of the present study was to test the hypothesis that endocardial extent of MI is more predictive of pathological Q waves than is MI transmurality and to investigate the relationship between QRS scoring of the ECG and MI characteristics. Twenty-nine patients with reperfused first-time MI were prospectively enrolled. One week after admission, delayed contrast-enhanced magnetic resonance imaging (DE-MRI) was performed and 12-lead ECG was recorded. Size, transmurality and endocardial extent of MI were assessed by DE-MRI. Q waves were identified with Minnesota coding and electrocardiographic MI size was estimated by QRS scoring of the ECG. There was a significant difference between patients with and without Q waves with regard to MI size (P = 0.03) and endocardial extent of MI (P = 0.01), but not to mean and maximum MI transmurality (P = 0.09 and P = 0.14). Endocardial extent was the only independent predictor of pathological Q waves. Endocardial extent of MI was most strongly correlated to QRS score (r = 0.86, P &lt; 0.001) of the MI variables tested. The endocardial extent of reperfused first-time acute MI is more predictive of pathological Q waves than is MI transmurality.},
  author       = {Engblom, Henrik and Carlsson, Minna B and Hedström, Erik and Heiberg, Einar and Ugander, Martin and Wagner, Galen S and Arheden, Håkan},
  issn         = {1475-0961},
  language     = {eng},
  number       = {2},
  pages        = {101--108},
  publisher    = {Wiley Online Library},
  series       = {Clinical Physiology and Functional Imaging},
  title        = {The endocardial extent of reperfused first-time myocardial infarction is more predictive of pathologic Q waves than is infarct transmurality: a magnetic resonance imaging study.},
  url          = {http://dx.doi.org/10.1111/j.1475-097X.2007.00723.x},
  volume       = {27},
  year         = {2007},
}