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(Circulation. 1997;96:3913-3920.)
© 1997 American Heart Association, Inc.
Articles |
QT Dispersion Is Determined by the Extent of Viable Myocardium in Patients With Chronic Q-Wave Myocardial Infarction
From Klinik III für Innere Medizin (C.A.S., F.M.B., U.S.), Klinik und Poliklinik für Nuklearmedizin (E.V.), Klinik und Poliklinik für Herz- und Thoraxchirurgie (M.H.), and Max-Planck-Institut für neurologische Forschung, Universität zu Köln (R.W.), Germany.
Correspondence to Christian Schneider, Klinik III für Innere Medizin, Universität zu Köln, Joseph Stelzmann Straße 9, 50934 Köln, Germany.
Background QT dispersion is lower in patients with successful thrombolysis after acute myocardial infarction, suggesting that QT dispersion may be determined by the extent of viable and scarred myocardium.
Methods and Results To test this hypothesis, QT dispersion
was measured in a 12-lead resting ECG in 44 patients with chronic
Q-wave myocardial infarction. To assess the extent of viable and
scarred myocardium, all patients underwent F-18
fluorodeoxyglucose (FDG) positron emission tomography (PET). In
addition, all patients had revascularization of the
infarct-related artery and repeated angiography 4 months later. QT
dispersion was lower (53±20 versus 94±24 ms, P<.0001)
in patients with evidence of a substantial amount of viable
myocardium in the infarct region as demonstrated by PET
(average FDG uptake 
50% of normalized, maximum FDG uptake) than in
patients with only minimal residual viability. Average FDG uptake of
the infarct region and FDG defect size were significantly related to QT
dispersion (r=.64, P<.0001;
r=.67, P<.0001), whereas ejection
fraction was not (r<.1, P=NS). QT
dispersion of 
70 ms had a sensitivity of 85% and a specificity of
82% to predict viable myocardium in the infarct region. QT
dispersion was also lower in patients with improvement of left
ventricular function 4 months after
revascularization (54±21 versus 88±30 ms,
P=.0003). QT dispersion of 70 ms had a sensitivity of
83% and a specificity of 71% to predict improvement of left
ventricular function.
Conclusions QT dispersion is determined by the amount of viable myocardium in the infarct region and may serve as a novel, rapidly available marker of substantial viability in the infarct region of patients with chronic Q-wave myocardial infarction.
Key Words: thrombolysis • myocardial infarction • revascularzation • myocardium
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