Greenspan M, Anderson G J
Am J Med. 1979 Sep;67(3):454-9. doi: 10.1016/0002-9343(79)90793-9.
The significance of transient exercise-induced Q waves present during treadmill testing was prospectively evaluated and correlated with the findings at cardiac catheterization. Exercise-induced Q waves were present in 14 of 560 patients (2.5 per cent) undergoing treadmill exercise testing. Thirteen patients had Q waves in leads V1 through V3 and one patient had Q waves in leads II, III and aVF. Ten patients underwent cardiac catheterization; six did not have coronary artery disease as determined by angiography. Two patients had a documented anterior myocardial infarction and did not undergo cardiac catheterization. Exercise myocardial perfusion imaging was performed in 10 patients. Six patients without coronary artery disease had no evidence of exercise perfusion defects. In the four patients with coronary artery disease, three patients had an abnormal resting perfusion study without change with exercise and one patient had a new exercise myocardial perfusion defect. We conclude that exercise-induced transient Q waves are not diagnostic of underlying coronary disease. In patients without coronary artery disease the mechanism of exercise-induced Q waves is as yet unclear. In patients with coronary artery disease, the mechanism may also be undefined or secondary to myocardial ischemia.
前瞻性评估了跑步机测试期间出现的短暂运动诱发Q波的意义，并将其与心导管检查结果相关联。在560例接受跑步机运动测试的患者中，有14例（2.5%）出现运动诱发Q波。13例患者的V1至V3导联出现Q波，1例患者的II、III和aVF导联出现Q波。10例患者接受了心导管检查；血管造影显示6例无冠状动脉疾病。2例有记录的前壁心肌梗死患者未接受心导管检查。10例患者进行了运动心肌灌注成像。6例无冠状动脉疾病的患者没有运动灌注缺损的证据。在4例有冠状动脉疾病的患者中，3例静息灌注研究异常，运动后无变化，1例出现新的运动心肌灌注缺损。我们得出结论，运动诱发的短暂Q波不能诊断潜在的冠状动脉疾病。在无冠状动脉疾病的患者中，运动诱发Q波的机制尚不清楚。在有冠状动脉疾病的患者中，其机制可能也不明确或继发于心肌缺血。
