LETTER TO THE EDITOR
Use of term "non-Q infarction" is questioned
Myrvin H. Ellestad, MD*
* Long Beach Memorial Medical Center, Memorial Heart Institute, 2801 Atlantic Avenue, Long Beach, California 90801-1428, USA
mellestad{at}memorialcare.org
The recent study in JACC titled "Revisiting the Culprit Lesion in Non–Q-Wave Myocardial Infarction" warrants comment (1). The term "non-Q infarction," so common in today’s literature, represents sloppy thinking and sloppy science. Infarcts due to circumflex disease may be very large and occasionally fatal and almost never cause Q-waves. Significant anterior wall infarction often reduces R-wave amplitude without resulting in Q-waves. The statement that non–Q-wave infarcts are different from those with Q-waves is using terminology that misrepresents the pathology. The viewpoint article by Phibbs and colleagues (2), reviewing this issue in detail three years ago in JACC, should be required reading. The editorial staff can discourage the use of this term by insisting that researchers who are ignorant of the pathology of infarction read the article by Phibbs et al.
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1. Kerensky RA, Wade M, Deedwania P, Boden WE, Pepine CJ. Revisiting the culprit lesion in non–Q-wave myocardial infarction: results from the VANQWISH trial angiographic core laboratory. J Am Coll Cardiol. 2002;39:1456–1463[Abstract/Free Full Text]
2. Phibbs B, Marcus F, Marriott HJC, Moss AJ. Q-wave versus non–Q-wave myocardial infarction: a meaningless distinction. J Am Coll Cardiol. 1999;33:576–582[Free Full Text]
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J. C. C. Moon, D. Perez De Arenaza, A. G. Elkington, A. K. Taneja, A. S. John, D. Wang, R. Janardhanan, R. Senior, A. Lahiri, P. A. Poole-Wilson, et al.
The pathologic basis of Q-wave and non-Q-wave myocardial infarction: A cardiovascular magnetic resonance study
J. Am. Coll. Cardiol.,
August 4, 2004;
44(3):
554 - 560.
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