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British Heart Journal logoLink to British Heart Journal
. 1987 Nov;58(5):460–464. doi: 10.1136/hrt.58.5.460

Residual myocardial jeopardy in patients with Q-wave and non-Q-wave infarctions.

J K Bissett 1, J Matts 1, B Sharma 1
PMCID: PMC1277340  PMID: 2890362

Abstract

The correlation between the presence of areas of jeopardized myocardium and the electrocardiographic patterns of anterior and inferior Q-wave and non-Q-wave infarctions was studied in 486 patients who had had stable symptoms for at least six months after a single myocardial infarction. Myocardial jeopardy was identified on a ventriculogram in the right anterior oblique position if normal or hypokinetic wall motion was seen in all segments distal to a lesion that caused stenosis of greater than 50% and less than 100% in the proximal or mid left anterior descending coronary artery (anterior jeopardy), or in the proximal or mid right coronary artery or proximal circumflex coronary artery in a left dominant circulation (inferior jeopardy). Patients with non-Q-wave anterior infarctions had a significant increase in the frequency of jeopardized myocardium when compared with patients with Q-wave inferior or anterior infarctions. The group with non-Q-wave anterior infarction also had a significantly lower percentage of myocardial segments with absent wall motion in the area of infarction than all other groups. This combination of coronary narrowing with retained wall motion may contribute to the increased frequency of reinfarction seen in some studies of non-Q-wave infarction.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alderman E. L., Fisher L., Maynard C., Mock M. B., Ringqvist I., Bourassa M. G., Kaiser G. C., Gillespie M. J. Determinants of coronary surgery in a consecutive patient series from geographically dispersed medical centers. The coronary artery surgery study. Circulation. 1982 Aug;66(2 Pt 2):I6–15. [PubMed] [Google Scholar]
  2. Buchwald H., Moore R. B., Varco R. L. Surgical treatment of hyperlipidemia. 3. Clinical status of the partial ileal bypass operation. Circulation. 1974 May;49(5 Suppl):I22–I37. [PubMed] [Google Scholar]
  3. Cannom D. S., Levy W., Cohen L. S. The short- and long-term prognosis of patients with transmural and nontransmural myocardial infarction. Am J Med. 1976 Oct;61(4):452–458. doi: 10.1016/0002-9343(76)90322-3. [DOI] [PubMed] [Google Scholar]
  4. DeWood M. A., Stifter W. F., Simpson C. S., Spores J., Eugster G. S., Judge T. P., Hinnen M. L. Coronary arteriographic findings soon after non-Q-wave myocardial infarction. N Engl J Med. 1986 Aug 14;315(7):417–423. doi: 10.1056/NEJM198608143150703. [DOI] [PubMed] [Google Scholar]
  5. Gibson R. S., Beller G. A., Gheorghiade M., Nygaard T. W., Watson D. D., Huey B. L., Sayre S. L., Kaiser D. L. The prevalence and clinical significance of residual myocardial ischemia 2 weeks after uncomplicated non-Q wave infarction: a prospective natural history study. Circulation. 1986 Jun;73(6):1186–1198. doi: 10.1161/01.cir.73.6.1186. [DOI] [PubMed] [Google Scholar]
  6. Hutter A. M., Jr, DeSanctis R. W., Flynn T., Yeatman L. A. Nontransmural myocardial infarction: a comparison of hospital and late clinical course of patients with that of matched patients with transmural anterior and transmural inferior myocardial infarction. Am J Cardiol. 1981 Oct;48(4):595–602. doi: 10.1016/0002-9149(81)90136-3. [DOI] [PubMed] [Google Scholar]
  7. Krone R. J., Friedman E., Thanavaro S., Miller J. P., Kleiger R. E., Oliver G. C. Long-term prognosis after first Q-wave (transmural) or non-Q-wave (nontransmural) myocardial infarction: analysis of 593 patients. Am J Cardiol. 1983 Aug;52(3):234–239. doi: 10.1016/0002-9149(83)90114-5. [DOI] [PubMed] [Google Scholar]
  8. Löfmark R. T wave changes and postinfarction angina pectoris predictive of recurrent myocardial infarction. Br Heart J. 1981 May;45(5):512–516. doi: 10.1136/hrt.45.5.512. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Madigan N. P., Rutherford B. D., Frye R. L. The clinical course, early prognosis and coronary anatomy of subendocardial infarction. Am J Med. 1976 May 10;60(5):634–641. doi: 10.1016/0002-9343(76)90497-6. [DOI] [PubMed] [Google Scholar]
  10. McKay R. G., Aroesty J. M., Heller G. V., Silverman K. J., Parker J. A., Als A. V., Come P. C., Kolodny G. M., Grossman W. The pacing stress test reexamined: correlation of pacing-induced hemodynamic changes with the amount of myocardium at risk. J Am Coll Cardiol. 1984 Jun;3(6):1469–1481. doi: 10.1016/s0735-1097(84)80286-7. [DOI] [PubMed] [Google Scholar]
  11. Spodick D. H. Transmural vs nontransmural infarction. Circulation. 1980 Aug;62(2):447–448. doi: 10.1161/01.cir.62.2.447. [DOI] [PubMed] [Google Scholar]
  12. Swan H. J. Newer technologies for study of the action of nitrates in coronary circulation and myocardial function. Am Heart J. 1985 Jul;110(1 Pt 2):233–237. doi: 10.1016/0002-8703(85)90492-2. [DOI] [PubMed] [Google Scholar]
  13. Szklo M., Goldberg R., Kennedy H. L., Tonascia J. A. Survival of patients with nontransmural myocardial infarction: a population-based study. Am J Cardiol. 1978 Oct;42(4):648–652. doi: 10.1016/0002-9149(78)90636-7. [DOI] [PubMed] [Google Scholar]
  14. Taylor G. J., Humphries J. O., Mellits E. D., Pitt B., Schulze R. A., Griffith L. S., Achuff S. C. Predictors of clinical course, coronary anatomy and left ventricular function after recovery from acute myocardial infarction. Circulation. 1980 Nov;62(5):960–970. doi: 10.1161/01.cir.62.5.960. [DOI] [PubMed] [Google Scholar]
  15. Thanavaro S., Krone R. J., Kleiger R. E., Province M. A., Miller J. P., deMello V. R., Oliver G. C. In-hospital prognosis of patients with first nontransmural and transmural infarctions. Circulation. 1980 Jan;61(1):29–33. doi: 10.1161/01.cir.61.1.29. [DOI] [PubMed] [Google Scholar]

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