Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Center of Excellence in Arrhythmia Research Chulalongkorn University, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Indian Heart J. 2022 Mar-Apr;74(2):105-109. doi: 10.1016/j.ihj.2022.02.001. Epub 2022 Feb 9.
The presence of a Q-wave on a 12-lead electrocardiogram (ECG) has been considered a marker of a large myocardial infarction (MI). However, the correlation between the presence of Q-waves and nonviable myocardium is still controversial. The aims of this study were to 1) test QWA, a novel ECG approach, to predict transmural extent and scar volume using a 3.0 Tesla scanner, and 2) assess the accuracy of QWA and transmural extent.
Consecutive patients with a history of coronary artery disease who came for myocardial viability assessment by CMR were retrospectively enrolled. Q-wave measurements parameters including duration and maximal amplitude were performed from each surface lead. A 3.0 Tesla CMR was performed to assess LGE and viability.
Total of 248 patients were enrolled in the study (with presence (n = 76) and absence of pathologic Q-wave (n = 172)). Overall prevalence of pathologic Q-waves was 27.2% (for LAD infarction patients), 20.0 % (for LCX infarction patients), and 16.8% (for RCA infarction patients). Q-wave area demonstrated high performance for predicting the presence of a nonviable segment in LAD territory (AUC 0.85, 0.77-0.92) and a lower, but still significant performance in LCX (0.63, 0.51-0.74) and RCA territory (0.66, 0.55-0.77). Q-wave area greater than 6 ms mV demonstrated high performance in predicting the presence of myocardium scar larger than 10% (AUC 0.82, 0.76-0.89).
Q-wave area, a novel Q-wave parameter, can predict non-viable myocardial territories and the presence of a significant myocardial scar extension.
12 导联心电图（ECG）上出现 Q 波一直被认为是大面积心肌梗死（MI）的标志物。然而，Q 波的存在与无活力心肌之间的相关性仍存在争议。本研究的目的是 1）测试 QWA，一种新的 ECG 方法，使用 3.0T 扫描仪预测透壁程度和疤痕体积，2）评估 QWA 和透壁程度的准确性。
回顾性纳入连续因冠心病就诊并接受 CMR 心肌存活评估的患者。从每个体表导联测量 Q 波测量参数，包括持续时间和最大幅度。进行 3.0T CMR 评估 LGE 和存活能力。
共有 248 例患者入组研究（病理性 Q 波存在组（n=76）和病理性 Q 波不存在组（n=172））。病理性 Q 波的总体发生率为 27.2%（LAD 梗死患者），20.0%（LCX 梗死患者）和 16.8%（RCA 梗死患者）。Q 波面积对预测 LAD 区域无活力节段的存在具有较高的性能（AUC 0.85，0.77-0.92），在 LCX（0.63，0.51-0.74）和 RCA 区域（0.66，0.55-0.77）仍具有一定的性能。Q 波面积大于 6ms mV 对预测大于 10%的心肌疤痕具有较高的性能（AUC 0.82，0.76-0.89）。
Q 波面积，一种新的 Q 波参数，可预测无活力心肌区域和存在显著的心肌疤痕扩展。
