Diagnostic Significance of a Small Q Wave in Precordial Leads V<sub>2</sub> or V<sub>3</sub>

Katsuno, Tetsuya; Hirao, Kazuyuki; Kimura, Shigeki; Komura, Masatoshi; Haraguchi, Go; Inagaki, Hiroshi; Isobe, Mitsuaki

doi:10.1111/j.1542-474x.2010.00351.x

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Improved electrocardiographic (ECG) recordings became an attractive approach for the diagnosis of myocardial infarction. Extensive efforts have been made to define criteria of alterations in different ECG waves associated with location and areas of myocardial infarction [1]–[4]. ST-segment elevation is a well recognized change in ECG recording in patients with myocardial infarction [5].…”

Section: Introductionmentioning

confidence: 99%

Decreases in Electrocardiographic R-Wave Amplitude and QT Interval Predict Myocardial Ischemic Infarction in Rhesus Monkeys with Left Anterior Descending Artery Ligation

et al. 2013

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Clinical studies have demonstrated the predictive values of changes in electrocardiographic (ECG) parameters for the preexisting myocardial ischemic infarction. However, a simple and early predictor for the subsequent development of myocardial infarction during the ischemic phase is of significant value for the identification of ischemic patients at high risk. The present study was undertaken by using non-human primate model of myocardial ischemic infarction to fulfill this gap. Twenty male Rhesus monkeys at age of 2–3 years old were subjected to left anterior descending artery ligation. This ligation was performed at varying position along the artery so that it produced varying sizes of myocardial infarction at the late stage. The ECG recording was undertaken before the surgical procedure, at 2 h after the ligation, and 8 weeks after the surgery for each animal. The correlation of the changes in the ECG waves in the early or the late stage with the myocardial infarction size was analyzed. The R wave depression and the QT shortening in the early ischemic stage were found to have an inverse correlation with the myocardial infarction size. At the late stage, the R wave depression, the QT prolongation, the QRS score, and the ST segment elevation were all closely correlated with the developed infarction size. The poor R wave progression was identified at both the early ischemic and the late infarction stages. Therefore, the present study using non-human primate model of myocardial ischemic infarction identified the decreases in the R wave and the QT interval as early predictors of myocardial infarction. Validation of these parameters in clinical studies would greatly help identifying patients with myocardial ischemia at high risk for the subsequent development of myocardial infarction.

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Section: Introductionmentioning

confidence: 99%

Decreases in Electrocardiographic R-Wave Amplitude and QT Interval Predict Myocardial Ischemic Infarction in Rhesus Monkeys with Left Anterior Descending Artery Ligation

et al. 2013

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“…[ 16 ] Regional fQRS patterns show the presence of a focal regional myocardial scar [ 17 ], and laterality of fQRS represents a lesion in the territory of the coronary artery [ 3 , 18 ]. Precordial small Q wave and/or fragmentation in leads V2 and V3 could predict the presence of coronary artery stenosis in the left anterior descending branch [ 19 ]. A regional scar results in localized systolic dysfunction, and fQRS was associated with local LV dysfunction detected by 2D strain imaging in CAD patients with preserved ejection fraction (EF) [ 20 ].…”

Section: Diagnosis Of Myocardial Scar In Coronary Artery Diseasementioning

confidence: 99%

Fragmented QRS: What Is The Meaning?

Take

Morita

2012

Indian Pacing and Electrophysiology Journal

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Fragmented QRS (fQRS) is a convenient marker of myocardial scar evaluated by 12-lead electrocardiogram (ECG) recording. fQRS is defined as additional spikes within the QRS complex. In patients with CAD, fQRS was associated with myocardial scar detected by single photon emission tomography and was a predictor of cardiac events. fQRS was also a predictor of mortality and arrhythmic events in patients with reduced left ventricular function. The usefulness of fQRS for detecting myocardial scar and for identifying high-risk patients has been expanded to various cardiac diseases, such as cardiac sarcoidosis, arrhythmogenic right ventricular cardiomyopathy, acute coronary syndrome, Brugada syndrome, and acquired long QT syndrome. fQRS can be applied to patients with wide QRS complexes and is associated with myocardial scar and prognosis. Myocardial scar detected by fQRS is associated with subsequent ventricular dysfunction and heart failure and is a substrate for reentrant ventricular tachyarrhythmias.

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Fragmentierter QRS-Komplex

Steger

Sinnecker

Berkefeld

et al. 2015

Herzschr Elektrophys

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The QRS complex represents the electrical depolarization of ventricular myocardium. In the case of an undisturbed depolarization, the QRS complex has a normal configuration and duration, but abnormal electrical conduction leads to widening of the QRS complex. The block of one of the Tawara branches results in a typical bundle branch block pattern. A QRS complex that cannot be classified as bundle branch block due to an atypical configuration and contains notched R or S waves is called a fragmented QRS. The underlying pathophysiologies are manifold and include myocardial scars induced by ischemic heart disease, myocardial fibrosis due to other diseases, primary cardiac pathologies as well as systemic diseases with cardiac involvement. Pathologies on the cellular level, such as ion channel dysfunctions, also correlate with fragmented QRS. Besides the diagnostic relevance, fragmented QRS is known to have prognostic properties, for example in identifying high risk patients with coronary artery disease, cardiomyopathy, Brugada syndrome and acquired long QT syndrome; however, fragmented QRS may also be detected in ECGs of healthy individuals.

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Diagnostic Significance of a Small Q Wave in Precordial Leads V₂ or V₃

Abstract: A small Q wave (<40-ms duration and <0.5-mV amplitude) in V(2) or V(3) with or without early fragmentation significantly predicted the presence of CAD and, especially, significant stenosis in the LAD.

Cited by 4 publications

References 11 publications

Decreases in Electrocardiographic R-Wave Amplitude and QT Interval Predict Myocardial Ischemic Infarction in Rhesus Monkeys with Left Anterior Descending Artery Ligation

Decreases in Electrocardiographic R-Wave Amplitude and QT Interval Predict Myocardial Ischemic Infarction in Rhesus Monkeys with Left Anterior Descending Artery Ligation

Fragmented QRS: What Is The Meaning?

Fragmentierter QRS-Komplex

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Diagnostic Significance of a Small Q Wave in Precordial Leads V2 or V3

Abstract: A small Q wave (<40-ms duration and <0.5-mV amplitude) in V(2) or V(3) with or without early fragmentation significantly predicted the presence of CAD and, especially, significant stenosis in the LAD.

Cited by 4 publications

References 11 publications

Decreases in Electrocardiographic R-Wave Amplitude and QT Interval Predict Myocardial Ischemic Infarction in Rhesus Monkeys with Left Anterior Descending Artery Ligation

Decreases in Electrocardiographic R-Wave Amplitude and QT Interval Predict Myocardial Ischemic Infarction in Rhesus Monkeys with Left Anterior Descending Artery Ligation

Fragmented QRS: What Is The Meaning?

Fragmentierter QRS-Komplex

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Product

Resources

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Diagnostic Significance of a Small Q Wave in Precordial Leads V₂ or V₃