Changes of electrocardiographic QRS complex in patients with acute ST-segment elevation myocardial infarction with different degree of myocardial ischemia and its predictive value for severe arrhythmias
10.3969/j.issn.1008-0074.2025.01.20
- VernacularTitle:不同心肌缺血程度急性ST段抬高型心肌梗死患者心电图QRS波群变化及其对严重心律失常的预测价值
- Author:
Hong-yan WANG
1
;
Qiao-wen ZHAO
;
Li HUANG
Author Information
1. 榆林市星元医院心电图室,陕西榆林 719000
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Arrhythmias;
Myocardial ischemia;
Electrocardiography
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2025;34(1):95-98
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the changes of QRS complex in ECG in patients with acute ST-segment eleva-tion myocardial infarction(STEMI)with different degree of myocardial ischemia and its predictive value for severe arrhythmias(SA).Methods:A total of 122 STEMI patients treated in Yulin Xingyuan Hospital between January 2020 and January 2021 were selected and divided into grade Ⅱ ischemia group(n=49)and grade Ⅲ ischemia group(n=73)according to morphology of QRS complex at admission.ST segment change in ECG at admission and 2h af-ter intravenous thrombolysis and incidence of SA during hospitalization were compared between two groups.Multi-variate Logistic regression was used to analyze influencing factors for SA in STEMI patients.Results:Compared with grade Ⅱ ischemia group,patients in grade Ⅲ ischemia group had significant higher amplitude of ST segment el-evation(∑ST)at admission[0.87(0.62,1.10)mV vs.0.42(0.29,0.57)mV],∑ST on 2h after intravenous thrombolysis[0.47(0.34,0.61)mV vs.0.12(0.09,0.15)mV]and incidence rate of SA during hospitaliza-tion(36.73％vs.9.59％)(P＜0.001 all),and significant lower proportion of ST segment resolution ≥50％on 2h after intravenous thrombolysis(59.18％vs.84.93％)(P＜0.001).Multivariate Logistic regression analysis indica-ted that onset-to-thrombolysis time,∑ST at admission,∑ST on 2h after intravenous thrombolysis and myocardi-al ischemia grade Ⅲ were independent risk factors for SA in STEMI patients(OR=1.240～3.236,P＜0.05 or＜0.01),while ST segment resolution ≥ 50％on 2h after intravenous thrombolysis was its independent protective fac-tor(OR=0.480,P=0.030).Conclusion:Grade Ⅲ myocardial ischemia is an independent risk factor for SA in STEMI patients,and myocardial ischemia may be a predictor for SA in STEMI patients.
