Significance of a fragmented QRS complex versus a Q wave in patients with coronary artery disease.


BACKGROUND:Q waves on a 12-lead ECG are markers of a prior myocardial infarction (MI). However, they may regress or even disappear over time, and there is no specific ECG sign of a non-Q-wave MI. Fragmented QRS complexes (fQRSs), which include various RSR' patterns, without a typical bundle-branch block are markers of altered ventricular depolarization owing to a prior myocardial scar. We postulated that the presence of an fQRS might improve the ability to detect a prior MI compared with Q waves alone by ECG. METHODS AND RESULTS:A cohort of 479 consecutive patients (mean+/-SD age, 58.2+/-13.2 years; 283 males) who were referred for nuclear stress tests was studied. The fQRS included various morphologies of the QRS (<120 ms), which included an additional R wave (R') or notching in the nadir of the S wave, or >1 R' (fragmentation) in 2 contiguous leads, corresponding to a major coronary artery territory. The Q wave was present in 71 (14.8%) patients, an fQRS was present in 191 (34.9%) patients, and an fQRS and/or a Q wave was present in 203 (42.3%) patients. Sensitivity, specificity, and the negative predictive value for myocardial scar as detected by single photon emission computed tomography analysis were 36.3%, 99.2%, and 70.8%, respectively, for the Q wave alone; 85.6%, 89%, and 92.7%, respectively, for the fQRS; and 91.4%, 89%, and 94.2%, respectively, for the Q wave and/or fQRS. CONCLUSIONS:The fQRS on a 12-lead ECG is a marker of a prior MI, defined by regional perfusion abnormalities, which has a substantially higher sensitivity and negative predictive value compared with the Q wave.






Das MK,Khan B,Jacob S,Kumar A,Mahenthiran J




Has Abstract


2006-05-30 00:00:00














  • A Cytokine-Like Protein Dickkopf-Related Protein 3 Is Atheroprotective.

    abstract:BACKGROUND:Dickkopf-related protein 3 (DKK3) is a secreted protein that is involved in the regulation of cardiac remodeling and vascular smooth muscle cell differentiation, but little is known about its role in atherosclerosis. METHODS:We tested the hypothesis that DKK3 is atheroprotective using both epidemiological a...


    pub_type: 杂志文章


    authors: Yu B,Kiechl S,Qi D,Wang X,Song Y,Weger S,Mayr A,Le Bras A,Karamariti E,Zhang Z,Barco Barrantes ID,Niehrs C,Schett G,Hu Y,Wang W,Willeit J,Qu A,Xu Q

    更新日期:2017-09-12 00:00:00

  • Targeted deletions of cyclooxygenase-2 and atherogenesis in mice.

    abstract:BACKGROUND:Although the dominant product of vascular Cyclooxygenase-2 (COX-2), prostacyclin (PGI(2)), restrains atherogenesis, inhibition and deletion of COX-2 have yielded conflicting results in mouse models of atherosclerosis. Floxed mice were used to parse distinct cellular contributions of COX-2 in macrophages and ...


    pub_type: 杂志文章


    authors: Hui Y,Ricciotti E,Crichton I,Yu Z,Wang D,Stubbe J,Wang M,Puré E,FitzGerald GA

    更新日期:2010-06-22 00:00:00

  • A prospective randomized study of a modified technique of ultrafiltration during pediatric open-heart surgery.

    abstract::Conventional ultrafiltration (UF) fails to reverse satisfactorily hemodilution and the rise in total body water (TBW) seen after cardiopulmonary bypass (CPB). We have modified the technique, timing, and placement of UF in the CPB circuit and in pilot studies observed controlled elevation of hematocrit and a significan...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Naik SK,Knight A,Elliott M

    更新日期:1991-11-01 00:00:00

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    pub_type: 杂志文章


    authors: Berkowitz C,McKeever L,Croke RP,Jacobs WR,Loeb HS,Gunnar RM

    更新日期:1977-12-01 00:00:00

  • Cariporide (HOE642), a selective Na+-H+ exchange inhibitor, inhibits the mitochondrial death pathway.

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    authors: Teshima Y,Akao M,Jones SP,Marbán E

    更新日期:2003-11-04 00:00:00

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    pub_type: 杂志文章


    authors: Grignani G,Soffiantino F,Zucchella M,Pacchiarini L,Tacconi F,Bonomi E,Pastoris A,Sbaffi A,Fratino P,Tavazzi L

    更新日期:1991-04-01 00:00:00

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    更新日期:2008-01-22 00:00:00

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    authors: Ferrans VJ,Spray TL,Billingham ME,Roberts WC

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    pub_type: 杂志文章


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    更新日期:1994-05-01 00:00:00

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    authors: Ferrari R,Bachetti T,Confortini R,Opasich C,Febo O,Corti A,Cassani G,Visioli O

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    pub_type: 杂志文章,多中心研究


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    authors: Macefield VG,Rundqvist B,Sverrisdottir YB,Wallin BG,Elam M

    更新日期:1999-10-19 00:00:00

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    authors: McCue CM,Mantakas ME,Tingelstad JB,Ruddy S

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    authors: Mahmud R,Lehmann M,Denker S,Gilbert CJ,Akhtar M

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    pub_type: 杂志文章


    authors: Chau NP,Mallion JM,de Gaudemaris R,Ruche E,Siche JP,Pelen O,Mathern G

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    pub_type: 杂志文章


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    pub_type: 杂志文章


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    pub_type: 临床试验,杂志文章,随机对照试验


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    pub_type: 杂志文章,多中心研究,随机对照试验


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    更新日期:2002-01-01 00:00:00

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    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Sklar J,Johnston GD,Overlie P,Gerber JG,Brammell HL,Gal J,Nies AS

    更新日期:1982-05-01 00:00:00

  • Severe aortic stenosis in patients 60 years of age or older: left ventricular function and 10-year survival after valve replacement.

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    pub_type: 杂志文章


    authors: Murphy ES,Lawson RM,Starr A,Rahimtoola SH

    更新日期:1981-08-01 00:00:00