Document Detail

Lack of pathologic Q waves: a specific marker of viability in myocardial hibernation.
MedLine Citation:
PMID:  18727077     Owner:  NLM     Status:  MEDLINE    
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<0.08). 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.
Hui-Kyung Jeon; Gopi A Shah; Abhinav Diwan; Jucylea M Cwajg; Tae-Ho Park; Marti L McCulloch; William A Zoghbi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  31     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-09-01     Completed Date:  2008-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  372-7     Citation Subset:  IM    
Department of Cardiology, The Methodist Hospital, Houston, Texas, USA.
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MeSH Terms
Coronary Angiography
Coronary Artery Disease / physiopathology
Echocardiography, Stress
Middle Aged
Myocardial Stunning / physiopathology*,  radionuclide imaging
Sensitivity and Specificity
Thallium Radioisotopes / diagnostic use
Tissue Survival / physiology*
Reg. No./Substance:
0/Thallium Radioisotopes; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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