HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Ottavio Alfieri Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Crescenzi, G. Articles by Alfieri, O. Search for Related Content PubMed PubMed Citation Articles by Crescenzi, G. Articles by Alfieri, O. Related Collections Myocardial infarction

Eur J Cardiothorac Surg 2004;25:1001-1005
© 2004 Elsevier Science NL

Clinical significance of a new Q wave after cardiac surgery

^a Department of Cardiovascular Anesthesia, IRCCS San Raffaele Hospital of Milan, Via Olgettina, 60, 20132 Milan, Italy
^b Department of Cardiac Surgery, IRCCS San Raffaele Hospital of Milan, Milan, Italy
^c Department of Mathematics, University of Milan, Milan, Italy

Received 18 November 2003; received in revised form 24 February 2004; accepted 25 February 2004.

^* Corresponding author. Tel.: +39-02-2643-7154/7164/4524; fax: +39-02-2643-7178/7155
e-mail: landoni.giovanni{at}hsr.it

Objective: The appearance of new Q waves on the electrocardiogram (ECG) after cardiac surgery has been traditionally considered a sign of major myocardial tissue damage. The aim of this study was to investigate the clinical significance of new Q waves appearing following cardiac surgery and to correlate them with the release of myocardial cell damage biomarkers. Methods: 206 consecutive patients undergoing cardiac surgery were prospectively evaluated. A 12 lead ECG was recorded and cardiac troponin I and creatinekinase subfraction MB assayed the day before surgery, on arrival at the intensive care Unit. 4 and 18 h postoperatively and every morning until the fifth postoperative day. Results: The incidence of new Q waves was 7.3%. Patients with isolated ECG findings had an uneventful postoperative course; on the contrary, when ECG changes were coupled with the release of myocardial necrosis biomarkers, patients had a complicated postoperative course. Conclusions: The association of a new Q wave and high levels of myocardial necrosis biomarkers is strongly associated with postoperative cardiac events. On the contrary, the isolated appearance of a new Q wave has no impact on the postoperative cardiac outcome.

Key Words: Myocardial infarction • Cardiac surgery • Electrocardiogram • Q wave • Troponin • Creatinekinase

This article has been cited by other articles:

				A. Espinoza, P. S. Halvorsen, L. Hoff, H. Skulstad, E. Fosse, H. Ihlen, and T. Edvardsen Detecting myocardial ischaemia using miniature ultrasonic transducers -- a feasibility study in a porcine model Eur. J. Cardiothorac. Surg., January 1, 2010; 37(1): 119 - 126. [Abstract] [Full Text] [PDF]

				G. A. Lurati Buse, M. T. Koller, M. Grapow, C. M. Bruni, J. Kasper, M. D. Seeberger, and M. Filipovic 12-month outcome after cardiac surgery: prediction by troponin T in combination with the European system for cardiac operative risk evaluation. Ann. Thorac. Surg., December 1, 2009; 88(6): 1806 - 1812. [Abstract] [Full Text] [PDF]

				P. S. Halvorsen, L. A. Fleischer, A. Espinoza, O. J. Elle, L. Hoff, H. Skulstad, T. Edvardsen, and E. Fosse Detection of myocardial ischaemia by epicardial accelerometers in the pig Br. J. Anaesth., January 1, 2009; 102(1): 29 - 37. [Abstract] [Full Text] [PDF]

				C. Simon, F. Capuano, A. Roscitano, U. Benedetto, C. Comito, and R. Sinatra Cardiac Troponin I vs EuroSCORE: Myocardial Infarction and Hospital Mortality Asian Cardiovasc Thorac Ann, April 1, 2008; 16(2): 97 - 102. [Abstract] [Full Text] [PDF]

				D. Paparella, G. Cappabianca, P. Malvindi, A. Paramythiotis, A. Galeone, N. Veneziani, C. Fondacone, and L. de Luca Tupputi Schinosa Myocardial injury after off-pump coronary artery bypass grafting operation Eur. J. Cardiothorac. Surg., September 1, 2007; 32(3): 481 - 487. [Abstract] [Full Text] [PDF]

				A. Chieffo, N. Morici, F. Maisano, E. Bonizzoni, J. Cosgrave, M. Montorfano, F. Airoldi, M. Carlino, I. Michev, G. Melzi, et al. Percutaneous Treatment With Drug-Eluting Stent Implantation Versus Bypass Surgery for Unprotected Left Main Stenosis: A Single-Center Experience Circulation, May 30, 2006; 113(21): 2542 - 2547. [Abstract] [Full Text] [PDF]

				D. Paparella, G. Cappabianca, G. Visicchio, A. Galeone, A. Marzovillo, N. Gallo, C. Memmola, and L. d. L. T. Schinosa Cardiac Troponin I Release After Coronary Artery Bypass Grafting Operation: Effects on Operative and Midterm Survival Ann. Thorac. Surg., November 1, 2005; 80(5): 1758 - 1764. [Abstract] [Full Text] [PDF]