Akademik Veri Yönetim Sistemi
Cardiology, cilt.103, sa.2, ss.73-78, 2005 (SCI-Expanded, Scopus)
We investigated whether spontaneous normalization of negative T waves (TWN) on infarct-related ECG leads (IRLs) in the chronic phase of Q wave anterior myocardial infarction (MI) could be a predictor of residual viability in infarct areas. We prospectively studied 35 patients (age 60 ± 8.6 years) in the chronic phase of Q wave anterior MI. Spontaneous TWN (group A, n = 23) were defined as negative T waves that became upright (≥0.15 mV) in ≥2 IRLs. The presence of negative T waves (group B, n = 12) was defined as symmetric or biphasic negative T wave of ≥0.15 mV. All patients underwent same-day rest 201TI-stress 99mTc sestamibi dual-isotope myocardial perfusion SPECT and 24-hour 201TI reinjection imaging for ischemia and viability analysis. On scintigraphic examination, ischecmic or viable myocardial segments were found in 18 patients (78%) with TWN and 4 patients (33%) of group B (p = 0.013). The use of TWN as a parameter had a marked influence on the sensitivity (82%), specificity (62%), positive (78%) and negative (67%) predictive values and accuracy (74%) of the diagnosis of viable myocardium. If we add the criterion of positive T waves in aVR with negative T waves to our criteria, we found that sensitivity (90%), positive (80%) and negative (80%) predictive values and accuracy (80%) increased. The results of our study suggest that analysis of TWN on IRLs is an accurate marker of residual viability and/or persistent peri-infarct ischemia in patients in the chronic stage of Q wave anterior MI, and therefore optimizes the diagnostic and therapeutic strategies after MI. Copyright 2005 S. Karger AG, Basel.