Iwasaki K, Kusachi S, Hina K, Yamasaki S, Kita T, Endo C, Tsuji T
Cardiovascular Center, Sakakibara Hospital, Okayama University Medical School, Japan.
Am J Cardiol. 1995 Jul 1;76(1):14-20. doi: 10.1016/s0002-9149(99)80793-0.
We examined the relation of Q-wave regression to left ventricular (LV) indexes in acute anterior wall myocardial infarction (AMI) in relation to reperfusion therapy. A total of 94 patients with their first anterior wall AMI (segment 6 or 7 occlusion according to the American Heart Association classification) were examined. The follow-up period with 12-lead electrocardiograms ranged from 6 to 60 months (mean 24 +/- 18). An abnormal Q wave was defined as > 40 ms and > 25% of the R-wave amplitude. Q-wave regression was defined as Q-wave disappearance and r-wave regression > 0.1 mV in > or = 1 lead. Contingency tables with the chi-square test and analysis of variance were used for assessment of the relation between Q-wave regression and angiographic and clinical indexes. Q-wave regression in > or = 1 lead was found in 77% of the patients. The incidence of Q-wave regression in patients with patent infarct-related artery (81%) was not significantly different from that in those with an occluded lesion (67%). Q-wave regression appeared within 1 month in 60% of patients with a patent infarct-related artery but in 25% of those with an occluded lesion. No difference in the incidence of Q-wave regression was seen between patients with lesions at segments 6 (81%) and 7 (70%), or between those with (75%) and without (77%) collateral circulation. Q-wave regression did not correlate with LV ejection fraction, LV end-diastolic or end-systolic volumes, or regional wall motion.(ABSTRACT TRUNCATED AT 250 WORDS)
我们研究了急性前壁心肌梗死(AMI)患者中Q波消退与左心室(LV)指标的关系,并与再灌注治疗相关。共检查了94例首次发生前壁AMI的患者(根据美国心脏协会分类,梗死部位为6或7段闭塞)。12导联心电图的随访期为6至60个月(平均24±18个月)。异常Q波定义为时限>40毫秒且幅度> R波幅度的25%。Q波消退定义为Q波消失且在≥1个导联中r波回升>0.1毫伏。使用列联表、卡方检验和方差分析来评估Q波消退与血管造影及临床指标之间的关系。77%的患者在≥1个导联中出现Q波消退。梗死相关动脉通畅的患者中Q波消退的发生率(81%)与梗死相关动脉闭塞的患者(67%)相比无显著差异。梗死相关动脉通畅的患者中60%在1个月内出现Q波消退,而梗死相关动脉闭塞的患者中这一比例为25%。6段(81%)和7段(70%)病变的患者之间,以及有(75%)和无(77%)侧支循环的患者之间,Q波消退的发生率均无差异。Q波消退与左心室射血分数、左心室舒张末期或收缩末期容积或局部室壁运动均无相关性。(摘要截短至250字)