Normalization of negative T waves in the chronic stage of Q wave anterior myocardial infarction as a predictor of myocardial viability
Küçük Resim Yok
Tarih
2005
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Karger
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
We investigated whether spontaneous normalization of negative T waves ( TWN) on infarct-related ECG leads ( IRLs) in the chronic phase of Q wave anterior myocardial infarction ( MI) could be a predictor of residual viability in infarct areas. We prospectively studied 35 patients ( age 60 +/- 8.6 years) in the chronic phase of Q wave anterior MI. Spontaneous TWN ( group A, n = 23) were defined as negative T waves that became upright ( greater than or equal to0.15 mV) in 62 IRLs. The presence of negative T waves ( group B, n = 12) was defined as symmetric or biphasic negative T wave of greater than or equal to0.15 mV. All patients underwent same-day rest Tl-201-stress Tc-99m sestamibi dual-isotope myocardial perfusion SPECT and 24-hour Tl-201 reinjection imaging for ischemia and viability analysis. On scintigraphic examination, ischemic or viable myocardial segments were found in 18 patients ( 78%) with TWN and 4 patients ( 33%) of group B ( p = 0.013). The use of TWN as a parameter had a marked influence on the sensitivity ( 82%), specificity ( 62%), positive ( 78%) and negative ( 67%) predictive values and accuracy ( 74%) of the diagnosis of viable smyocardium. If we add the criterion of positive T waves in aVR with negative T waves to our criteria, we found that sensitivity ( 90%), positive ( 80%) and negative ( 80%) predictive values and accuracy ( 80%) increased. The results of our study suggest that analysis of TWN on IRLs is an accurate marker of residual viability and/or persistent peri-infarct ischemia in patients in the chronic stage of Q wave anterior MI, and therefore optimizes the diagnostic and therapeutic strategies after MI. Copyright (C) 2005 S. Karger AG, Basel.
Açıklama
Anahtar Kelimeler
Myocardial Infarction, T Wave Normalization, Scintigraphy, Viability, Myocardial, Leads, Echocardiography, Improvement
Kaynak
Cardiology
WoS Q Değeri
Q2
Scopus Q Değeri
Q3
Cilt
103
Sayı
2
