Parsa Saeed Alipour, Shahnazi Anahita, Malek Azadeh, Azargashb Eznollah, Mohammadi Manijeh, Beyranvand Mohammad-Reza
Department of Internal Medicine, Division of Cardiac Diseases, Labbafinejad Medical Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Clin Med Insights Cardiol. 2010 Jul 22;4:45-8. doi: 10.4137/cmc.s5135.
There is conflicting data about the predictive value of absent septal q wave in patients with significant stenosis of proximal Left Anterior Descending coronary artery. To clarify the exact role of this simple electrocardiographic sign we conducted this prospective descriptive study.
Patients who were referred for coronary angiography in Milad Hospital between December 2008 and September 2009 were chosen randomly. Standard ECG was performed and reviewed for presence or absence of septal q wave, and then the coronary angiography was done and reported by another cardiologist.
Of 148 patients with absent septal q wave in ECG, 85 patients (57%) had significant stenosis of proximal LAD in coronary angiography. Statistical analysis showed that significant stenosis of proximal LAD could be predicted by absence of septal q wave in ECG with sensitivity of 59% and specificity of 47%. However, Kappa statistic (Kappa = 0.36) showed low agreement between them.
Absence of normal septal q wave in ECG could be a low value predictor of coronary artery disease mainly significant proximal LAD stenosis.
关于前降支近端严重狭窄患者中室间隔q波缺失的预测价值，数据存在冲突。为阐明这一简单心电图征象的确切作用，我们开展了这项前瞻性描述性研究。
随机选取2008年12月至2009年9月间在米拉德医院接受冠状动脉造影的患者。进行标准心电图检查并复查是否存在室间隔q波，然后由另一位心脏病专家进行冠状动脉造影并报告结果。
在心电图室间隔q波缺失的148例患者中，85例（57%）在冠状动脉造影中显示前降支近端严重狭窄。统计分析表明，心电图室间隔q波缺失可预测前降支近端严重狭窄，敏感性为59%，特异性为47%。然而，Kappa统计量（Kappa = 0.36）显示两者之间一致性较低。
心电图中正常室间隔q波缺失可能是冠状动脉疾病（主要是前降支近端严重狭窄）的低价值预测指标。
