[Non-Q wave and Q wave myocardial infarct: correlation with regional myocardial perfusion, wall function and prognosis within 1 year].
The pathophysiologic substrate and the prognostic value of pathologic Q-waves after an acute myocardial infarction are still unclear. To elucidate this problem we stratified 52 postinfarction patients into those with Q-infarctions (n = 23) and those with non-Q-infarctions (n = 29). The localization and the extent of reversible and irreversible perfusion defects were assessed using dipyridamole-thallium-201 tomography (SPECT); in addition, coronary morphology, left ventricular wall motion, and prognosis were followed for 1 year. The Q-wave group showed a total defect size of 44.0 +/- 15.3% and a reversible defect size of 13.9 +/- 10% of the left ventricular myocardium. This was not significantly different from the non-Q-wave group, with a mean total defect of 35.2 +/- 20.7% and a mean reversible defect of 16.6 +/- 12.9%. However, the size of the irreversible defects in Q-wave infarctions was larger than in non-Q-wave infarctions (30.6 +/- 18.2% vs 18.6 +/- 17.5%; p less than 0.02). In addition, the relative portion of the reversible defect was larger in non-Q-infarctions than in Q-infarctions (55.9 +/- 25.7% vs 35.7 +/- 21.3%; p less than 0.01). Q-wave infarctions had a significantly lower LVEF of 55.7 +/- 15.4%, as compared to non-Q-infarctions (66.2 +/- 11.9%) (p less than 0.02). The extent of disease, as measured by coronary score and regional wall motion, was similar, but non-Q-wave infarctions were associated with a higher reinfarction rate (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Salge
D
D
Abteilungen für Kardiologie und Nuklearmedizin, Universitätskrankenhauses Eppendorf, Hamburg.
Nienaber
C A
CA
Spielmann
R P
RP
Bleifeld
W
W
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D003326:Coronary Circulation / Q000502:physiology*; D004562:Electrocardiography; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis*; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009203:Myocardial Infarction / Q000175:diagnosis*; D011379:Prognosis; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes
"Non-Q-wave"- und "Q-wave-Myokardinfarkt": Korrelation mit regionaler Myokardperfusion, Wandfunktion und Prognose innerhalb eines Jahres.