Abstract 1192: Wall Motion Abnormalities Detected by Cardiovascular Magnetic Resonance Are Associated with Electrocardiographic Q Waves in a Free-Living Population
Electrocardiographic (ECG) Q waves have moderate sensitivity for coronary heart disease (CHD). Resting left ventricular wall motion abnormalities (WMA) are detected by cardiovascular magnetic resonance (CMR) in subjects with and without overt CHD. We hypothesized that ECG Q waves are associated with CMR WMA in a free-living population. 1794 Framingham Heart Study Offspring Cohort participants (844M, 65±9 yrs) underwent both ECG and CMR. Pathologic ECG Q waves at any study examination, indicating past Q wave MI (QWMI), were adjudicated. CMR wall motion was scored using a 17-segment model (5 point scale). Abnormal wall motion score index (WMSI=wall motion score/# segments) was defined as WMSI >19/17 (≥2 contiguous dysfunctional segments). CMR left ventricular mass (LVM), end-diastolic volume (LVEDV), and ejection fraction (EF) were measured. Framingham risk score (FRS) was computed. Presence of QWMI was analyzed using Chi-squared test and logistic regression. Log-transformed WMSI and CMR measures were analyzed using Student’s t-test and ANCOVA. Logistic models and ANCOVA were adjusted for age and sex and separately adjusted for FRS. QWMI and WMA were present in 2.9% and 6.5% of the group, respectively. A WMA was detected in 65% of subjects with and 5% of subjects without Q waves. In both age/sex- and FRS-adjusted models, QWMI was strongly associated with WMA, logWMSI, and FRS (all p<0.0001, TABLE⇓). In FRS-adjusted analysis, WMA was associated with a 29-fold increased odds of QWMI (OR=29.4; 95% CI 15.7–55.0, p<0.0001). QWMI was associated with increased LVM, LVMI, and LVEDV, and decreased EF in FRS-adjusted analyses. In this free-living population, WMA and WMSI correlated strongly with presence of pathologic Q waves, even after FRS adjustment. QWMI was associated with increased LVMI, LVEDV, and decreased EF. Further study is required to determine the prognostic significance of WMA in subjects with and without Q waves.