Assessment of viable tissue in Q-wave regions by metabolic imaging using single-photon emission computed tomography in ischemic cardiomyopathy.

Abstract

Chronic electrocardiographic Q waves are often believed to reflect irreversibly scarred, transmurally infarcted myocardium. The aim of this study was to evaluate whether residual viable tissue persists in dysfunctional myocardial regions related to chronic Q waves on the surface electrocardiogram. A total of 148 patients with healed myocardial infarction and impaired left ventricular (LV) function with heart failure symptoms underwent electrocardiography and metabolic imaging using technetium (Tc-99m) tetrofosmin/F18-fluorodeoxyglucose (FDG) single-photon emission computed tomography (SPECT). The left ventricle was divided into 4 major regions to compare myocardial viability in regions with and without chronic Q waves on surface electrocardiography. According to FDG SPECT metabolic imaging, residual viable tissue persisted in a high proportion (61%) of dysfunctional myocardial regions with chronic Q waves. Regions with chronic Q waves were more often dysfunctional than regions without Q waves. Moreover, dysfunctional regions with chronic Q waves were less frequently viable compared with dysfunctional regions without Q waves on the electrocardiogram. This study demonstrates that chronic Q waves on electrocardiography do not necessarily imply irreversibly scarred myocardium. Residual viable tissue persists in a high proportion of dysfunctional ventricular regions according to FDG SPECT metabolic imaging.

• Authors: Arend F L Schinkel, Jeroen J Bax, Abdou Elhendy, Eric Boersma, Eleni C Vourvouri, Fabiola B Sozzi, Roelf Valkema, Jos R T C Roelandt, Don Poldermans
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 89 Issue 10 Pg. 1171-5 (May 15 2002) ISSN: 0002-9149 [Print] United States
• PMID: 12008170 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Aged
• Cardiomyopathies (complications, diagnosis)
• Echocardiography
• Electrocardiography
• Female
• Fluorodeoxyglucose F18
• Heart Ventricles (diagnostic imaging)
• Humans
• Image Enhancement
• Male
• Middle Aged
• Myocardial Ischemia (complications, diagnosis)
• Radiopharmaceuticals
• Stroke Volume (physiology)
• Tomography, Emission-Computed, Single-Photon
• Ventricular Dysfunction, Left (complications, diagnosis)