Early Q-wave morphology in prediction of reperfusion success in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention – A cardiac magnetic resonance imaging study
(2020) In Journal of Electrocardiology 58. p.135-142- Abstract
Background: Pathological Q-wave (QW) in the electrocardiogram (ECG) before primary percutaneous coronary intervention (primary PCI) is a strong prognostic marker in patients with ST-segment elevation myocardial infarction (STEMI). However, current binary QW criteria are either not clinically applicable or have a lack of diagnostic performance. Accordingly, we evaluated the association between duration, depth and area of QW and markers of the effect of reperfusion (reperfusion success). Methods: A total of 516 patients with their first STEMI had obtained an ECG before primary PCI and an acute cardiac magnetic resonance imaging (CMR) at day 1 (interquartile range [IQR], 1–1) and at follow-up at day 92 (IQR, 89–96). The largest measurable... (More)
Background: Pathological Q-wave (QW) in the electrocardiogram (ECG) before primary percutaneous coronary intervention (primary PCI) is a strong prognostic marker in patients with ST-segment elevation myocardial infarction (STEMI). However, current binary QW criteria are either not clinically applicable or have a lack of diagnostic performance. Accordingly, we evaluated the association between duration, depth and area of QW and markers of the effect of reperfusion (reperfusion success). Methods: A total of 516 patients with their first STEMI had obtained an ECG before primary PCI and an acute cardiac magnetic resonance imaging (CMR) at day 1 (interquartile range [IQR], 1–1) and at follow-up at day 92 (IQR, 89–96). The largest measurable QW in ECG was used for analysis of duration, depth and area of QW (QW morphology). The QW morphology was evaluated as a continuous variable in linear regression models and as a variable divided in four equally large groups. Results: The QW morphology as four equally large groups was significantly associated with all CMR endpoints (p ≤ 0.001) and showed a linear relationship (p ≤ 0.001) with final infarct size (for QW duration, β = 0.47; QW depth, β = 0.41 and QW area, β = 0.39), final infarct transmurality (for QW duration, β = 0.36; QW depth, β = 0.26 and QW area, β = 0.23) and final myocardial salvage index (for QW duration, β = −0.34; QW depth, β = −0.26 and QW area, β = −0.24). Conclusion: Although modest, the QW morphology in STEMI patients showed significant linear association with markers of reperfusion success. Hence, it is suggested that the term pathological is not used as a dichotomous parameter in patients with STEMI but rather evaluated on the basis of extent.
(Less)
- author
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Catheterization, Electrocardiogram, Magnetic resonance imaging, Myocardial infarction, Reperfusion
- in
- Journal of Electrocardiology
- volume
- 58
- pages
- 8 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:31869764
- scopus:85076717129
- ISSN
- 0022-0736
- DOI
- 10.1016/j.jelectrocard.2019.12.011
- language
- English
- LU publication?
- no
- id
- 737e179d-306f-4f5b-8c20-245a85a9a45f
- date added to LUP
- 2020-01-03 10:46:18
- date last changed
- 2024-10-02 18:48:54
@article{737e179d-306f-4f5b-8c20-245a85a9a45f,
abstract = {{<p>Background: Pathological Q-wave (QW) in the electrocardiogram (ECG) before primary percutaneous coronary intervention (primary PCI) is a strong prognostic marker in patients with ST-segment elevation myocardial infarction (STEMI). However, current binary QW criteria are either not clinically applicable or have a lack of diagnostic performance. Accordingly, we evaluated the association between duration, depth and area of QW and markers of the effect of reperfusion (reperfusion success). Methods: A total of 516 patients with their first STEMI had obtained an ECG before primary PCI and an acute cardiac magnetic resonance imaging (CMR) at day 1 (interquartile range [IQR], 1–1) and at follow-up at day 92 (IQR, 89–96). The largest measurable QW in ECG was used for analysis of duration, depth and area of QW (QW morphology). The QW morphology was evaluated as a continuous variable in linear regression models and as a variable divided in four equally large groups. Results: The QW morphology as four equally large groups was significantly associated with all CMR endpoints (p ≤ 0.001) and showed a linear relationship (p ≤ 0.001) with final infarct size (for QW duration, β = 0.47; QW depth, β = 0.41 and QW area, β = 0.39), final infarct transmurality (for QW duration, β = 0.36; QW depth, β = 0.26 and QW area, β = 0.23) and final myocardial salvage index (for QW duration, β = −0.34; QW depth, β = −0.26 and QW area, β = −0.24). Conclusion: Although modest, the QW morphology in STEMI patients showed significant linear association with markers of reperfusion success. Hence, it is suggested that the term pathological is not used as a dichotomous parameter in patients with STEMI but rather evaluated on the basis of extent.</p>}},
author = {{Topal, Divan Gabriel and Lønborg, Jacob and Ahtarovski, Kiril Aleksov and Nepper-Christensen, Lars and Fakhri, Yama and Helqvist, Steffen and Holmvang, Lene and Høfsten, Dan and Køber, Lars and Kelbæk, Henning and Vejlstrup, Niels and Engstrøm, Thomas}},
issn = {{0022-0736}},
keywords = {{Catheterization; Electrocardiogram; Magnetic resonance imaging; Myocardial infarction; Reperfusion}},
language = {{eng}},
pages = {{135--142}},
publisher = {{Elsevier}},
series = {{Journal of Electrocardiology}},
title = {{Early Q-wave morphology in prediction of reperfusion success in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention – A cardiac magnetic resonance imaging study}},
url = {{http://dx.doi.org/10.1016/j.jelectrocard.2019.12.011}},
doi = {{10.1016/j.jelectrocard.2019.12.011}},
volume = {{58}},
year = {{2020}},
}