Association between fragmented QRS complexes and imperfect ST-segment resolution in patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention
10.3760/cma.j.issn.0253-3758.2014.05.012
- VernacularTitle:碎裂QRS波与急性心肌梗死急诊介入治疗后ST段回落不良的关系
- Author:
Wenting DUAN
1
;
Xianghong MA
;
Lijun CUI
Author Information
1. 300211,天津医科大学第二医院心脏内科
- Keywords:
Coronary disease;
Electrocardiography;
Angioplasty,transluminal,percutaneous coronary
- From:
Chinese Journal of Cardiology
2014;42(5):400-405
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between fragmented QRS complexes (fQRS)and imperfect ST-segment resolution in ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (p-PCI).Methods This study included 227 consecutive patients with STEMI who underwent p-PCI.They were divided into two groups:ECG with fQRS (n =142)and without fQRS (n =85).Baseline clinical characteristics,Gensini score,coronary angiography features and the rate of ST-segment resolution were compared between the two groups.Results (1) Patients with fQRS of ECG had higher cTnI,CK,CK-MB levels and Gensini score,prolonged QRS interval,lower rate of ST-segment resolution and left ventricular ejection fraction (LVEF) than in patients without fQRS (all P ＜ 0.01 or P ＜ 0.05).(2) Pearson correlation analysis showed that the rate of ST-segment resolution (r =-0.207,P =0.002),Gensini score (r =0.191,P =0.004),LVEF (r =-0.188,P =0.006),cTnI (r =0.172,P =0.010),and the TIMI grade post p-PCI (r =-0.148,P =0.028) were significantly related with the presence of fQRS.(3) Multivariate logistic regression analysis demonstrated that presence of fQRS at pre-PCI (OR =2.908,95％ CI:1.095-7.723,P =0.032),the number of leads with fQRS before PCI (OR =1.582,95％ CI:1.250-2.002,P ＜ 0.001),and increased QRS interval (OR =0.955,95％ CI:0.924-0.988,P =0.008) were independent predictors of imperfect ST-segment resolution.Conclusions fQRS is related to imperfect ST-segment resolution in STEMI patients undergoing p-PCI.fQRS may be a useful parameter to identify the patients with severe coronary lesion,larger areas of ischemic injury and myocardial infarction as well as severe left ventricular contracted dysfunction.
