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European Heart Journal 1998 19(5):742-746; doi:10.1053/euhj.1997.0850
Copyright © 1998 by the European Society of Cardiology.
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Significance of Q-wave regression after anterior wall acute myocardial infarction

K. Nagase, A. Tamuraf1, Y. Mikuriya and M. Nasu

Second Department of Internal Medicine, Oita Medical University, Hasama, Oita, Japan

accepted November 21, 1997

Aims

This study was conducted to clarify the significance of abnormal Q-wave regression in anterior wall acute myocardial infarction.

Methods

A total of 74 patients who presented with a first anterior wall acute myocardial infarction within 6h of onset were divided into two groups according to the presence (group A, n=29) or absence (group B, n=45) of regression of abnormal Q waves. Regression of abnormal Q waves was defined as the disappearance of the Q wave and the reappearance of the r wave ≥0·1mV in at least one of leads I, aVL, and V1to V6.

Results

Emergency coronary arteriography revealed that group A had a higher incidence of spontaneous recanalization or good collateral circulation than group B (55% vs 31%,P<0·05). Peak creatine kinase activity tended to be lower in group A than in group B (2358±1796 vs 3092±1946IU.L–1,P=0·09). Group A had a greater left ventricular ejection fraction and better regional wall motion at 1 and 6 months after acute myocardial infarction than group B. The degree of improvement of left ventricular ejection fraction and regional wall motion between 1 and 6 months after acute myocardial infarction was significantly greater in group A than in group B.

Conclusion

Patients with anterior wall acute myocardial infarction showing Q-wave regression had a trend towards a smaller amount of necrotic myocardium and a significantly larger amount of stunned myocardium.

Key Words: Anterior wall acute myocardial infarction • abnormal Q wave • left ventricular wall motion

f1 Correspondence: Akira Tamura, MD, Second Department of Internal Medicine, Oita Medical University, Hasama, Oita 879-5593, Japan.


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