Relation of T-wave inversion in Q-wave acute myocardial infarction to myocardial viability on resting rubidium-82 and 18-fluoro-deoxyglucose positron emission tomography imaging.
T-wave inversion in areas of Q-wave myocardial infarction has been advocated as a predictor of myocardial viability. However, the predictive value of this electrocardiographic finding in distinguishing viable from nonviable muscle is not fully defined. Thus, we correlated electrocardiographic Q waves and a measure of T-wave inversion with the results of rubidium-82 (Rb-82) and 18-fluoro-deoxyglucose-positron emission tomography (FDG-PET) imaging at rest. We analyzed 35 Q-wave myocardial infarct regions in 25 patients. Nineteen of the 35 (54%) were judged viable by Rb-82/FDG-PET. Using the Novacode T-wave score, T-wave inversion was present in 11 of 19 regions (58%) with viability and 5 of 16 regions (31%) without viability. Thus, neither Q waves nor T-wave inversion can accurately predict myocardial viability in patients with Q-wave myocardial infarction.
Beth Israel Medical Center, University Hospital, Albert Einstein College of Medicine, New York, New York, USA.
Jonathan
J
Rosman
Sam
S
Hanon
Michael
M
Shapiro
Paul
P
Schweitzer
Andrew
A
Van Tosh
D000208:Acute Disease; D004562:Electrocardiography; D019788:Fluorodeoxyglucose F18; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology*; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000473:pathology*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes
D019275:Radiopharmaceuticals; D012414:Rubidium Radioisotopes; D019788:Fluorodeoxyglucose F18