Abstract
QT interval and QT dispersion both prolong early postinfarction. Non-Q wave (NQMI) and Q-wave myocardial infarction (QMI) differ in the extent of transmural necrosis, which may influence these measures of myocardial repolarization. This study compared dynamic changes in QT interval and QT dispersion early postinfarction between NQMI and QMI. In 40 patients with NQMI and 69 patients with QMI, maximum QTc (QTc max) and QT dispersion (QTD) were measured during the first 4 days postinfarction. Infarct size was assessed daily by using the Selvester QRS score. In both infarct types, QTc max and QTD were prolonged on day 1 of infarction, peaking over the next 2 days before returning toward baseline by day 4. NQMI patients had significantly longer QTc max and QTD by days 2 to 3 when compared with QMI patients. Multivariable linear regression identified “infarct type × QRS score” as the only independent predictor of QTc max ( R 2 = .32, P < .0001) and QTD ( R 2 = .19, P < .0001) on day 2. In conclusion, dynamic changes of QTc max and QTD occur in both infarct types. Large NQMI is associated with greater prolongation of QTc max and QTD, which may be due to greater M cell uncoupling and exposure when compared with QMI.
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