title: Assessment of viable tissue in Q-wave regions by metabolic imaging using single-photon emission computed tomography in ischemic cardiomyopathy.
abstract: Chronic electrocardiographic Q waves are often believed to reflect irreversibly scarred, transmurally infarcted myocardium. The aim of this study was to evaluate whether residual viable tissue persists in dysfunctional myocardial regions related to chronic Q waves on the surface electrocardiogram. A total of 148 patients with healed myocardial infarction and impaired left ventricular (LV) function with heart failure symptoms underwent electrocardiography and metabolic imaging using technetium (Tc-99m) tetrofosmin/F18-fluorodeoxyglucose (FDG) single-photon emission computed tomography (SPECT). The left ventricle was divided into 4 major regions to compare myocardial viability in regions with and without chronic Q waves on surface electrocardiography. According to FDG SPECT metabolic imaging, residual viable tissue persisted in a high proportion (61%) of dysfunctional myocardial regions with chronic Q waves. Regions with chronic Q waves were more often dysfunctional than regions without Q waves. Moreover, dysfunctional regions with chronic Q waves were less frequently viable compared with dysfunctional regions without Q waves on the electrocardiogram. This study demonstrates that chronic Q waves on electrocardiography do not necessarily imply irreversibly scarred myocardium. Residual viable tissue persists in a high proportion of dysfunctional ventricular regions according to FDG SPECT metabolic imaging.
authors: Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Arend F L
authors: AF
authors: Schinkel
authors: Jeroen J
authors: JJ
authors: Bax
authors: Abdou
authors: A
authors: Elhendy
authors: Eric
authors: E
authors: Boersma
authors: Eleni C
authors: EC
authors: Vourvouri
authors: Fabiola B
authors: FB
authors: Sozzi
authors: Roelf
authors: R
authors: Valkema
authors: Jos R T C
authors: JR
authors: Roelandt
authors: Don
authors: D
authors: Poldermans
mesh_terms: D000368:Aged; D009202:Cardiomyopathies / Q000150:complications* / Q000175:diagnosis*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D019788:Fluorodeoxyglucose F18; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis*; D019275:Radiopharmaceuticals; D013318:Stroke Volume / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18