SIGNIFICANCE OF Q-WAVE REGRESSION AFTER ANTERIOR WALL ACUTE MYOCARDIAL-INFARCTION

Aims This study was conducted to clarify the significance of abnormal Q-wave regression in anterior wall acute myocardial infarction. Method s A total of 74 patients who presented with a first anterior wall acut e myocardial infarction within 6 h of onset were divided into two grou ps 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 wa s defined as the disappearance of the Q wave and the reappearance of t he r wave greater than or equal to 0.1 mV in at least one of leads I, aVL, and V-1 to V-6. 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 cr eatine kinase activity tended to be lower in group A than in group B ( 2358 +/- 1796 vs 3092 +/- 1946 IU.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 deg ree of improvement of left ventricular ejection fraction and regional wall motion between I and 6 months after acute myocardial infarction w as significantly greater in group A than in group B. Conclusion Patien ts with anterior wall acute myocardial infarction showing Q-wave regre ssion had a trend towards a smaller amount of necrotic myocardium and a significantly larger amount of stunned myocardium.