SENSITIVITY OF ECG SIGNS OF MYOCARDIAL SCARING – COMPARISON WITH MPI SPECT
Aim of the study was to compare the sensitivity and specificity of the ECG sign of myocardial necrosis – sequel Q, by using MPI SPECT study findings as a gold standard. All patients included in the study had fixed perfusion defect on the MPI SPECT study. We analyzed patients characteristics: gender, age, presence of significant Q wave on ECG (determined as >40 msec length and amplitude of >1/3 of accompanying R wave), present in at least two consecutive ECG leads, presence of fixed perfusion defect on MPI SPECT study, corresponding to the vascular territory. Data collection was made from patients medical records, ECG recording, and MPI SPECT study performed as one day rest/stress ECG gated study with Tc99m sestamibi, using Dipyridamole as vasodilating stressor. Significant Q-wave was recorded in 13 (41.9%) subjects, 5 in ECG leads corresponding to the inferior wall, 4 to the anterior wall, 3 both the inferior and the anterior wall, and 1 in the inferolateral wall. Only 41.9% of patients with myocardial infarction (detected with MPI SPECT study), had ECG sign of sequela, which indicates that ECG signs of myocardial scaring as a result of myocardial infarction are quite insensitive, as proven with concomitant performing of MPI SPECT study.
Abdulla J, Brendorp B, Torp-Pedersen C et al. Does the electrocardiographic presence of Q waves influence the survival of patients with acute myocardial infarction? Eur Heart J, 2001; 22: 1008–1014
Congestive heart feailure and heart disease
Einstein AJ, Blankstein R, Andrews H, Fish M, Padgett R, Hayes SW, et al. Comparison of Image Quality, Myocardial Perfusion, and Left Ventricular Function Between Standard Imaging and Single-Injection Ultra-Low-Dose Imaging Using a High-Efficiency SPECT Camera: The MILLISIEVERT Study. J Nucl Med. 2014 Jun 30.
Furman MI, Dauerman HL, Goldberg RJ et al. Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial Q-wave and non-Q-wave myocardial infarction: a multi-hospital, community-wide perspective. J Am Coll Cardiol, 2001; 37: 1571–1580.
Loong CY, Anagnostopoulos C. Diagnosis of coronary artery disease by radionuclide myocardial perfusion imaging. Heart. 2004 Aug. 90 Suppl 5:v2-9.
Mozzafarian D, Benjamin EJ, Go AS, et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2016;133:e38-e360.
Samieinasab M, Shirani S, Hashemi SM et al. Non-administration of thrombolytic agents in acute myocardial infarction patients in Hajar hospital, Shahrekord, Iran: prevalence rate and causes. ARYA Atheroscler, 2013; 9: 115–118.
WHO. The global burden of disease: 2004 update. Available at: www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html.
Yang H, Pu M, Rodriguez D et al. Ischemic and viable myocardium in patients with non-Q-wave or Q-wave myocardial infarction and left ventricular dysfunction: a clinical study using positron emission tomography, echocardiography, and electrocardiography. J Am Coll Cardiol, 2004; 43: 592–598
Yasuda M, Iida H, Itagane H et al. Significance of Q wave disappearance in the chronic phase following transmural acute myocardial infarction. Jpn Circ J, 1990; 54: 1517–1524.