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

Hua Yang, Min Pu*, David Rodriguez, Donald Underwood, Brian P. Griffin, Vidyasagar Kalahasti, James D. Thomas, Richard C. Brunken

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

OBJECTIVES: We investigated whether patients with non-Q-wave myocardial infarction (NQMI) have more ischemic viable myocardium (IVM) than patients with Q-wave myocardial infarction (QMI). BACKGROUND: Non-Q-wave myocardial infarction is associated with higher incidences of cardiac events than QMI, suggesting more myocardium at risk in NQMI. METHODS: To identify myocardial ischemia, hibernation, and scar, the resting and stress 82rubidium perfusion and F-18 fluorodeoxyglucose metabolic positron emission tomographic imaging (PET) was performed in 64 consecutive patients with NQMI (n = 21) or QMI (n = 43). Echocardiography was performed for assessment of left ventricular function and wall motion index (WMI). The relationships between PET, echocardiographic, and electrocardiographic findings were analyzed. RESULTS: There were no significant differences in left ventricular ejection fraction (LVEF) between NQMI and QMI groups (28 ± 10% vs. 25 ± 11%, p > 0.05). Ischemic and viable myocardium was more common in NQMI than in QMI (91% vs. 61%, p < 0.05). The total amount of IVM was significantly higher in NQMI than in QMI (6.5 ± 5.2 vs. 2.9 ± 2.8 segments, p < 0.001). Neither the number of Q waves, residual ST-segment depression of ≥0.5 mm or elevation of ≥1 mm, nor LVEF and WMI were significant predictors for IVM. Wall motion index correlated with scar segments (r = 0.54, p < 0.001) and LVEF (r = -0.67, p < 0.001). CONCLUSIONS: Ischemic and viable myocardium is common in patients with NQMI and left ventricular dysfunction, suggesting that aggressive approaches should be taken to salvage the myocardium at risk in such patients.

Original languageEnglish (US)
Pages (from-to)592-598
Number of pages7
JournalJournal of the American College of Cardiology
Volume43
Issue number4
DOIs
StatePublished - Feb 18 2004

Keywords

  • Fluorodeoxyglucose-18
  • Ischemic viable myocardium
  • Left ventricular ejection fraction
  • Myocardial infarction
  • Non-Q-wave myocardial infarction
  • Positron emission tomography
  • Q-wave myocardial infarction
  • Rubidium-82
  • Wall motion score index

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this