Lack of Pathologic Q Waves: A Specific Marker of Viability in Myocardial Hibernation

Background The present study evaluates the lack of Q waves on the electrocardiogram (ECG) in the prediction of myocardial viability compared with dobutamine stress echocardiography (DSE) and rest-redistribution thallium-201 (Tl-201) scintigraphy. Hypothesis The lack of pathologic Q waves (NoQ) may be a readily available and specific marker for the presence of viability. Methods Sixty four patients with stable coronary artery disease (CAD) and ventricular dysfunction underwent rest ECG, DSE, and Tl-201 scintigraphy before revascularization, and a repeat rest 2-Dimensional (2-D) echocardiogram more than 3 mo later. Results Total viability at baseline (% of total segments) was higher in the NoQ group by Tl-201 scintigraphy (87 ± 19% versus 70 ± 20%, p = 0.008) and by DSE (81 ± 20% versus 65 ± 24%, p = 0.013). As expected, the sensitivity of NoQ waves was low in predicting recovery of function (23%), and inferior to Tl-201 (82%) and DSE (84%) (p