Normalization of Negative T Waves in the Chronic Stage of Q Wave Anterior Myocardial Infarction as a Predictor of Myocardial Viability.
In: Cardiology, Jg. 103 (2005-02-01), Heft 2, S. 73-78
Online
academicJournal
Zugriff:
We investigated whether spontaneous normalization of negative T waves (TWN) on infarct-related ECG leads (IRLs) in the chronic phase of Q wave anterior myocardial infarction (MI) could be a predictor of residual viability in infarct areas. We prospectively studied 35 patients (age 60 ± 8.6 years) in the chronic phase of Q wave anterior MI. Spontaneous TWN (group A, n = 23) were defined as negative T waves that became upright (≥0.15 mV) in ≥2 IRLs. The presence of negative T waves (group B, n = 12) was defined as symmetric or biphasic negative T wave of ≥0.15 mV. All patients underwent same-day rest 201Tl-stress 99mTc sestamibi dual-isotope myocardial perfusion SPECT and 24-hour 201Tl reinjection imaging for ischemia and viability analysis. On scintigraphic examination, ischemic or viable myocardial segments were found in 18 patients (78%) with TWN and 4 patients (33%) of group B (p = 0.013). The use of TWN as a parameter had a marked influence on the sensitivity (82%), specificity (62%), positive (78%) and negative (67%) predictive values and accuracy (74%) of the diagnosis of viable myocardium. If we add the criterion of positive T waves in aVR with negative T waves to our criteria, we found that sensitivity (90%), positive (80%) and negative (80%) predictive values and accuracy (80%) increased. The results of our study suggest that analysis of TWN on IRLs is an accurate marker of residual viability and/or persistent peri-infarct ischemia in patients in the chronic stage of Q wave anterior MI, and therefore optimizes the diagnostic and therapeutic strategies after MI. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
Titel: |
Normalization of Negative T Waves in the Chronic Stage of Q Wave Anterior Myocardial Infarction as a Predictor of Myocardial Viability.
|
---|---|
Autor/in / Beteiligte Person: | Altun, Armagan ; Durmus-Altun, Gulay ; Birsin, Atilla ; Gultekin, Aziz ; Tatli, Ersan ; Ozbay, Gultac |
Link: | |
Zeitschrift: | Cardiology, Jg. 103 (2005-02-01), Heft 2, S. 73-78 |
Veröffentlichung: | 2005 |
Medientyp: | academicJournal |
ISSN: | 0008-6312 (print) |
DOI: | 10.1159/000082051 |
Schlagwort: |
|
Sonstiges: |
|