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Predictive Value of Absent Septal q Wave in Patients with Significant Stenosis of Proximal Left Anterior Descending

Saeed Alipour Parsa1, Anahita Shahnazi, Azadeh Malek

  • 1Department of Internal Medicine, Division of Cardiac Diseases, Labbafinejad Medical Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.

Clinical Medicine Insights. Cardiology
|September 23, 2010
PubMed

Insights

The absence of a normal septal q wave on an electrocardiogram (ECG) has a low predictive value for significant proximal Left Anterior Descending (LAD) coronary artery stenosis. This simple ECG sign shows low agreement with coronary angiography findings.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Electrocardiography

Background:

  • Conflicting data exists regarding the predictive value of absent septal q waves in Left Anterior Descending (LAD) coronary artery disease.
  • A simple electrocardiographic (ECG) sign, the septal q wave, is being investigated for its role in predicting significant proximal LAD stenosis.

Purpose of the Study:

  • To clarify the exact role of absent septal q waves in predicting significant stenosis of the proximal LAD coronary artery.
  • To evaluate the sensitivity and specificity of absent septal q waves as a predictor of proximal LAD stenosis.

Main Methods:

  • A prospective descriptive study was conducted involving patients referred for coronary angiography.
  • Standard ECGs were reviewed for the presence or absence of septal q waves.
  • Coronary angiography was performed and reported by a separate cardiologist to assess for significant proximal LAD stenosis.

Main Results:

  • Of 148 patients with absent septal q waves on ECG, 85 (57%) had significant proximal LAD stenosis.
  • The absence of septal q waves showed a sensitivity of 59% and a specificity of 47% in predicting significant proximal LAD stenosis.
  • Kappa statistic indicated a low agreement (Kappa = 0.36) between absent septal q waves and significant proximal LAD stenosis.

Conclusions:

  • Absence of a normal septal q wave on ECG is a low-value predictor for coronary artery disease, particularly significant proximal LAD stenosis.
  • The predictive value of this ECG finding is limited, with low sensitivity and specificity.
  • Further research may be needed to identify more reliable ECG markers for coronary artery disease.
Abstract

Keywords:
proximal LADseptal q wavessignificant stenosis

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