Q-Wave Regression Unrelated to Patency of Infarct-Related Artery or Left Ventricular Ejection Fraction or Volume after Anterior Wall Acute Myocardial Infarction Treated With or Without Reperfusion Therapy

We examined the relation of Q-wave regression to left ventricular (LV) indexes in acute anterior wall myocardial infarction (AMI) in relation to reperfusion therapy. A total of 94 patients with their first anterior wall AMI (segment 6 or 7 occlusion according to the American Heart Association classification) were examined. The follow-up period with 12-lead electrocardiograms ranged from 6 to 60 months (mean 24 ± 18). An abnormal Q wave was defined as >40 ms and >25% of the R-wave amplitude. Q-wave regression was defined as Q-wave disappearance and Q-wave regression >0.1 mV in ≥1 lead. Contingency tables with the chi-square test and analysis of variance were used for assessment of the relation between Q-wave regression and angiographic and clinical indexes. Q-wave regression in ≥1 lead was found in 77% of the patients. The incidence of Q-wave regression in patients with patent infarct-related artery (81%) was not significantly different from that in those with an occluded lesion (67%). Q-wave regression appeared within 1 month in 60% of patients with a patent infarct-related artery but in 25% of those with an occluded lesion. No difference in the incidence of Q-wave regression was seen between patients with lesions at segments 6 (81%) and 7 (70%), or between those with (75%) and without (77%) collateral circulation. Q-wave regression did not correlate with LV ejection fraction, LV end-diastolic or end-systolic volumes, or regional wall motion. In conclusion, Q-wave regression in patients with anterior wall AMI does not reflect improvement in LV function and its prognostic significance is poor.