Q-wave prediction of myocardial infarct location, size and transmural extent at magnetic resonance imaging
- 1 August 2007
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Coronary Artery Disease
- Vol. 18 (5), 381-389
- https://doi.org/10.1097/mca.0b013e32820588c2
Abstract
Objective We investigated how pathologic Q waves or equivalents predict location, size and transmural extent of myocardial infarction (MI). Methods MI characteristics, detected by contrast-enhanced magnetic resonance imaging, were compared with 12-lead electrocardiogram in 79 patients with previous first MI. Results Q waves involved only the anterior leads (V1–V4) in 13 patients: in all patients MI involved the anterior and anteroseptal walls and apex; 81% of scar tissue was within these regions. Q waves involved only the inferior leads (II, III, aVF) in 13 patients: in 12 of these patients MI involved the inferior and inferoseptal walls; however, only 59% of scar occupied these regions. Q waves involved only lateral leads (V5, V6, I, aVL) in 11 patients: in nine of these patients MI involved the lateral wall but only 27% of scar tissue was within this wall. Q waves involved two electrocardiogram locations in 42 patients. In the 79 patients as a whole, the number of anterior Q waves was related to anterior MI size (r=0.70); however, the number of inferior and lateral Q waves was only weakly related to MI size in corresponding territories (r=0.35 and 0.33). A tall and broad R wave in V1–V2 was a more powerful predictor of lateral MI size than Q waves. Finally, the number of Q waves accurately reflected the transmural extent of the infarction (r=0.70) only in anterior infarctions. Conclusion Q waves reliably predict MI location, size and transmural extent only in patients with anterior infarction. A tall and broad R wave in V1–V2 reflects a lateral MI.Keywords
This publication has 31 references indexed in Scilit:
- Size and transmural extent of first-time reperfused myocardial infarction assessed by cardiac magnetic resonance can be estimated by 12-lead electrocardiogramAmerican Heart Journal, 2005
- The relationship between electrical axis by 12-lead electrocardiogram and anatomical axis of the heart by cardiac magnetic resonance in healthy subjectsAmerican Heart Journal, 2005
- Quantitative clinical assessment of chronic anterior myocardial infarction with delayed enhancement magnetic resonance imaging and QRS scoringAmerican Heart Journal, 2003
- Correlation of postmortem anatomic findings with electrocardiographic changes in patients with myocardial infarction: retrospective study of patients with typical anterior and posterior infarcts.Circulation, 1977
- Disappearance of the Q-deflection following myocardial infarctionAmerican Heart Journal, 1968
- Correlation of Vectorcardiographic Criteria for Myocardial Infarction with Autopsy FindingsCirculation, 1967
- The Recognition of Strictly Posterior Myocardial Infarction by Conventional Scalar ElectrocardiographyCirculation, 1964
- V. Correlation of electrocardiographic and pathologic findings in posterior infarctionAmerican Heart Journal, 1949
- VII. Correlation of electrocardiographic and pathologic findings in lateral infarctionAmerican Heart Journal, 1949
- I. Correlation of electrocardiographic and pathologic findings in anteroseptal infarctionAmerican Heart Journal, 1948