QT Dispersion Is Determined by the Extent of Viable Myocardium in Patients With Chronic Q-Wave Myocardial Infarction

Schneider, Christian A.; Voth, E.; Baer, Frank M.; Horst, Michael; Wagner, Rainer; Sechtem, Udo

doi:10.1161/01.cir.96.11.3913

Cited by 85 publications

(47 citation statements)

References 26 publications

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“…The inclusion of hypertensive patients in the control group may have also been responsible for reducing the differences between the groups. In addi-Vol 43 No 5 tion, the present study only provided one point data in each patient with chronic myocardial infarction. Accordingly, longitudinal studies are needed to establish the changes in QTc dispersion over time.…”

Section: Discussionmentioning

confidence: 99%

“…4) Gabrielli, et al 20) reported that QT dispersion was increased soon after infarction and then decreased again after ten days, although not all patients showed improvement. Schneider, et al 5) studied patients in the chronic phase of infarction and found that QT dispersion was decreased in patients who showed improvement in wall motion after four months, while it showed little change in those without improvement in wall motion, suggesting that QT dispersion could be used as an index of cardiac function in chronic myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] However, the dispersion of ventricular repolarization may depend on the time after myocardial infarction, the location and size of the infarct, the presence or absence of residual ischemia, and the patient's drug therapy. The effects of time after infarction, 4) residual ischemia, [5][6][7] and various drugs 8,9) have already been studied. Regarding the infarct location and size, Raev, et al 10) and Mirvis, et al 11) have reported on the QT inter-val, while Moreno, et al 12) studied QT dispersion after acute myocardial infarction.…”

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confidence: 99%

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Relationship between Infarction Location and Size to QT Dispersion in Patients with Chronic Myocardial Infarction.

et al. 2002

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SUMMARYThe relationship between the location and size of an infarction and QT dispersion was investigated in 84 Japanese patients with chronic myocardial infarction (54 with anteroseptal infarction and 30 with inferior infarction). The control group consisted of 23 subjects without ischemic heart disease (13 normal subjects and 10 hypertensive patients). Corrected QT dispersion (maximum corrected QT interval minus minimum corrected QT interval: QTc dispersion), was significantly larger in the anterior infarction group than in the control group (69.9±21.5 msec vs 53.0±17.6 msec), while the inferior infarction group showed no significant difference from control subjects. QTc dispersion was significantly greater in the patients with large anterior infarcts than in those with small anterior infarcts (80.5±20.5 msec vs 61.9±18.8 msec). In patients with chronic myocardial infarction, QT dispersion is influenced by the infarct location and size. Accordingly, interpretation of QT dispersion data should take these factors into consideration. (Jpn Heart J 2002; 43: 455-461)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Relationship between Infarction Location and Size to QT Dispersion in Patients with Chronic Myocardial Infarction.

et al. 2002

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“…Some discrepancy between ECG location of Q waves, and echocardiographic and scintigraphic studies in the regional analysis may be due to anatomic misregistration of segments. Whether or not other aspects of the ECG are helpful in predicting viability, particularly QT dispersion, 15 were not explored in this investigation, mostly to assess the application of a simple parameter that can be used by any clinician at the bedside in the evaluation of myocardial viability.…”

Section: Study Limitationsmentioning

confidence: 99%

Lack of Pathologic Q Waves: A Specific Marker of Viability in Myocardial Hibernation

Jeon

Shah

Diwan

et al. 2008

Clinical Cardiology

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Background: The present study evaluates the lack of Q waves on the electrocardiogram (ECG) in the prediction of myocardial viability compared with dobutamine stress echocardiography (DSE) and rest-redistribution thallium-201 (Tl-201) scintigraphy. Hypothesis: The lack of pathologic Q waves (NoQ) may be a readily available and specific marker for the presence of viability. Methods: Sixty four patients with stable coronary artery disease (CAD) and ventricular dysfunction underwent rest ECG, DSE, and Tl-201 scintigraphy before revascularization, and a repeat rest 2-Dimensional (2-D) echocardiogram more than 3 mo later. Results: Total viability at baseline (% of total segments) was higher in the NoQ group by Tl-201 scintigraphy (87±19% versus 70±20%, p = 0.008) and by DSE (81±20% versus 65±24%, p = 0.013). As expected, the sensitivity of NoQ waves was low in predicting recovery of function (23%), and inferior to Tl-201 (82%) and DSE (84%) (p<0.05). However, specificity of NoQ waves for predicting recovery of global function was high (72%); higher than Tl-201 (50%) and DSE (45%). Positive predictive values were comparable among all modalities. Results were similar if the data were analyzed regionally for viability. Conclusion: Lack of pathologic Q waves is a specific and readily available marker of myocardial viability in patients with chronic CAD, which should alert the clinician for myocardial hibernation.

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“…Various ECG parameters at rest or during exercise were applied to assess myocardial viability or recovery of functionfor example, QT dispersion and T-wave normalization 9,10 -in a population with severely diseased but mostly patent arteries. The extent of Q waves in the resting ECG was used to assess a QRS score (Selvester Score) to predict infarct size and LV function after myocardial infarction (MI).…”

Section: Introductionmentioning

confidence: 99%

Resting 12-lead electrocardiogram as a reliable predictor of functional recovery after recanalization of chronic total coronary occlusions

et al. 2005

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SummaryBackground: A major goal of revascularization is the recovery of left ventricular (LV) function. Nuclear imaging techniques are widely used for detecting recovery of function with a good sensitivity, but only moderate specificity. Predictors of recovery in chronic total coronary occlusions (CTO) are not investigated.Hypothesis: The 12-lead-resting electrocardiogram (ECG) is a predictor of LV recovery after successful recanalization of CTO.Methods: Successful recanalization of CTO was performed in 127 patients. Of these, 62 patients, who constitute the study group, had impaired regional wall motion prior to recanalization. The 12-lead resting ECG was evaluated for Q-wave areas and parameters of QT dispersion. Impairment of regional wall motion was evaluated by LV angiogram at baseline and at follow-up.Results: Angiographic follow-up after 5 ± 1.4 months documented reocclusion in eight patients. Complete follow-up with a patent coronary artery and an ECG without bundlebranch block was available in 43 patients. Wall motion severity index (WMSI) improved from Ϫ2.92 ± 0.28 to Ϫ1.34 ± 0.61 (p < 0.001) in patients without Q waves, whereas it was unchanged in patients with Q waves (Ϫ3.01 ± 0.30 and Ϫ2.81 ± 0.32). Absence of Q waves at baseline predicted recovery of regional wall motion with 89% sensitivity and 67% specifici-

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QT Dispersion Is Determined by the Extent of Viable Myocardium in Patients With Chronic Q-Wave Myocardial Infarction

Abstract: QT dispersion is determined by the amount of viable myocardium in the infarct region and may serve as a novel, rapidly available marker of substantial viability in the infarct region of patients with chronic Q-wave myocardial infarction.

Cited by 85 publications

References 26 publications

Relationship between Infarction Location and Size to QT Dispersion in Patients with Chronic Myocardial Infarction.

Relationship between Infarction Location and Size to QT Dispersion in Patients with Chronic Myocardial Infarction.

Lack of Pathologic Q Waves: A Specific Marker of Viability in Myocardial Hibernation

Resting 12-lead electrocardiogram as a reliable predictor of functional recovery after recanalization of chronic total coronary occlusions

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