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Absent right precordial R waves are associated with reduced left ventricular function and poor prognosis in patients
1Central Middlesex Hospital, Cardiology Unit, Acton Lane, NW10 7NS, London, UK.
Right precordial Q waves in aortic stenosis patients indicate impaired left ventricular function and a worse prognosis. This ECG finding, present in nearly a third of patients, is linked to reduced systolic function and increased mortality.
Area of Science:
- Cardiology
- Electrocardiography
- Echocardiography
Background:
- Right precordial Q waves can mimic anterior myocardial infarction.
- Aortic stenosis is a significant cardiovascular condition affecting the left ventricle.
- The prognostic implications of right precordial Q waves in aortic stenosis are not fully understood.
Purpose of the Study:
- To investigate the relationship between right precordial Q waves and left ventricular function.
- To assess the prognostic significance of right precordial Q waves in patients with aortic stenosis.
- To differentiate the cause of right precordial Q waves in aortic stenosis patients without prior myocardial infarction.
Main Methods:
- Studied 49 patients with aortic stenosis and no history of myocardial infarction.
- Utilized electrocardiography (ECG), clinical history, and echocardiography for assessment.
- Compared left ventricular function and survival rates between patients with and without right precordial Q waves (V1 and V2).
Main Results:
- 31% of patients exhibited Q waves in V1 and V2.
- Patients with right precordial Q waves showed significantly reduced left ventricular shortening fraction, ejection fraction, and circumferential fiber shortening.
- A significantly higher mortality rate (60%) was observed in patients with right precordial Q waves compared to those without (15%) during follow-up.
Conclusions:
- A right precordial QS ECG pattern is found in approximately one-third of aortic stenosis patients.
- This ECG pattern is associated with impaired left ventricular systolic function.
- Right precordial Q waves in aortic stenosis portend an adverse prognosis and higher mortality risk.
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