Prediction of nonviable myocardium by ECG Q-Wave parameters: A 3.0 T cardiovascular magnetic resonance study

The presence of a Q-wave on a 12-lead electrocardiogram (ECG) has been considered a marker of a large myocardial infarction (MI). However, the correlation between the presence of Q-waves and nonviable myocardium is still controversial. The aims of this study were to 1) test QWA, a novel ECG approach...

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Bibliographic Details
Published in:Indian heart journal 2022-03, Vol.74 (2), p.105-109
Main Authors: Kumpamool, Pathompong, Chokesuwattanaskul, Ronpichai, Petchlorlian, Aisawan, Theerasuwipakorn, Nonthikorn, Vorasettakarnkij, Yongkasem, Tumkosit, Monravee, Makarawate, Pattarapong, Boonyaratavej, Smonporn, Chattranukulchai, Pairoj
Format: Article
Language:English
Subjects:
Cardiac MRI
Original
Q-wave
Scar
Viability
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Summary:The presence of a Q-wave on a 12-lead electrocardiogram (ECG) has been considered a marker of a large myocardial infarction (MI). However, the correlation between the presence of Q-waves and nonviable myocardium is still controversial. The aims of this study were to 1) test QWA, a novel ECG approach, to predict transmural extent and scar volume using a 3.0 Tesla scanner, and 2) assess the accuracy of QWA and transmural extent. Consecutive patients with a history of coronary artery disease who came for myocardial viability assessment by CMR were retrospectively enrolled. Q-wave measurements parameters including duration and maximal amplitude were performed from each surface lead. A 3.0 Tesla CMR was performed to assess LGE and viability. Total of 248 patients were enrolled in the study (with presence (n = 76) and absence of pathologic Q-wave (n = 172)). Overall prevalence of pathologic Q-waves was 27.2% (for LAD infarction patients), 20.0 % (for LCX infarction patients), and 16.8% (for RCA infarction patients). Q-wave area demonstrated high performance for predicting the presence of a nonviable segment in LAD territory (AUC 0.85, 0.77–0.92) and a lower, but still significant performance in LCX (0.63, 0.51–0.74) and RCA territory (0.66, 0.55–0.77). Q-wave area greater than 6 ms mV demonstrated high performance in predicting the presence of myocardium scar larger than 10% (AUC 0.82, 0.76–0.89). Q-wave area, a novel Q-wave parameter, can predict non-viable myocardial territories and the presence of a significant myocardial scar extension.
ISSN:0019-4832
2213-3763
DOI:10.1016/j.ihj.2022.02.001