Lack of pathologic Q waves: A specific marker of viability in myocardial hibernation

Hui Kyung Jeon, Gopi A. Shah, Abhinav Diwan, Jucylea M. Cwajg, Tae Ho Park, Marti L. McCulloch, William A. Zoghbi

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)372-377
Number of pages6
JournalClinical Cardiology
Volume31
Issue number8
DOIs
StatePublished - Aug 2008

Keywords

  • Dobutamine stress echocardiography
  • Electrocardiogram
  • Ischemic heart disease
  • Myocardial hibernation
  • Thallium scintigraphy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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