Document Detail


Resting 12-lead electrocardiogram as a reliable predictor of functional recovery after recanalization of chronic total coronary occlusions.
MedLine Citation:
PMID:  16028465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: 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 bundle-branch block was available in 43 patients. Wall motion severity index (WMSI) improved from -2.92 +/- 0.28 to -1.34 +/- 0.61 (p < 0.001) in patients without Q waves, whereas it was unchanged in patients with Q waves (-3.01 +/- 0.30 and -2.81 +/- 0.32). Absence of Q waves at baseline predicted recovery of regional wall motion with 89% sensitivity and 67% specificity. Positive predictive value for recovery was 68% in patients without Q waves, but only 11% in patients with Q waves. In multivariate analysis, only absence of Q waves predicted improvement in WMSI (p = 0.01). CONCLUSIONS: In patients with recanalization of CTO, recovery of regional wall motion is reliably predicted by analysis of the resting 12-lead ECG for pathologic Q waves.
Authors:
Ralf Surber; Gero Schwarz; Hans R Figulla; Gerald S Werner
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  28     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-07-20     Completed Date:  2005-10-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  293-7     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine I, Division of Cardiology and Angiology, Friedrich Schiller University, Jena, Germany. ralf.surber@med.uni-jena.de
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography
Coronary Stenosis / physiopathology*,  radiography,  surgery
Electrocardiography / methods*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Contraction / physiology
Myocardial Revascularization*
Predictive Value of Tests
Rest / physiology*
Retrospective Studies
Treatment Outcome
Ventricular Function, Left / physiology*

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


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