Significance of Q wave disappearance in the chronic phase following transmural acute myocardial infarction.

Authors:
  • HIHidetaka Iida
    Hidetaka Iida
  • HIHiroshi Itagane
    Hiroshi Itagane
  • ATAkira Tahara
    Akira Tahara
  • ITIku Toda
    Iku Toda
  • KAKaname Akioka
    Kaname Akioka
  • MTMasakazu Teragaki
    Masakazu Teragaki
  • HOHisao Oku
    Hisao Oku
  • KTKazuhide Takeuchi
    Kazuhide Takeuchi
  • TTTadanao Takeda
    Tadanao Takeda
  • HYHiroyuki Yamagishi
    Hiroyuki Yamagishi
  • TNTakahiko Naruko
    Takahiko Naruko
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Abstract
The mechanism and prognostic implications of Q wave regression following transmural acute myocardial infarction (AMI) were assessed in 54 patients. Of these subjects, 14 lost their Q waves. Exercise myocardial thallium-201 (201Tl) scintigraphy and two-dimensional echocardiography were performed before the patients were discharged from hospital. Two-dimensional echocardiography and electrocardiography were simultaneously repeated about 18 months after AMI. Both the relative 201Tl activity in the infarcted area and the improvement of echocardiographic wall motion index were higher in patients who had lost their Q waves than in those with retained Q waves (70 +/- 14% vs 58 +/- 13%, p less than 0.01; 5.2 +/- 3.0 vs 2.0 +/- 3.4, p less than 0.01, respectively). The prevalence of post-infarction angina pectoris was significantly higher in the former (29% vs 0%, p less than 0.01). We concluded that remnants of viable myocardial muscle might be responsible for Q wave regression following transmural acute myocardial infarction, and the prevalence of post-infarction angina pectoris was high among these patients.