The assessment of relationship between fragmented QRS complex and left ventricular wall motion score index in patients with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention
- STEMI hastalarında fQRS varlığı, yüksek Duvar Hareket Skoru İndeksi (WMSI) ve düşük sol ventrikül ejeksiyon fraksiyonu ile doğrudan ilişkilidir.
- fQRS pozitifliği olan hastalarda hastane içi kalp yetmezliği, reinfarktüs ve majör istenmeyen kardiyovasküler olaylar (MACE) görülme sıklığı anlamlı derecede daha yüksektir.
- Başvuru anındaki fQRS varlığı, uzun dönemli kardiyovasküler ölümler ve tüm nedenlere bağlı mortalite riskinin arttığını gösteren kritik bir prognostik göstergedir.
İçerik yapay zeka ile optimize edilmiştir
Fragmented QRS and Its Clinical Significance in STEMI Patients
This retrospective study investigates the clinical implications of fragmented QRS (fQRS) on admission electrocardiograms (ECG) in patients diagnosed with ST-elevation myocardial infarction (STEMI). The research focuses on the relationship between fQRS and myocardial injury markers, specifically the Wall Motion Score Index (WMSI) and long-term patient outcomes following primary percutaneous coronary intervention (PCI).
Study Methodology and Patient Classification
The study cohort consisted of 542 patients who underwent primary PCI after a STEMI diagnosis. To ensure a comparative analysis, the participants were categorized into two distinct groups based on their admission ECG findings:
- fQRS(+) Group: Patients presenting with fragmented QRS (n = 153).
- fQRS(-) Group: Patients without fragmented QRS (n = 389).
Analysis of Results and Clinical Outcomes
The findings revealed that the Wall Motion Score Index (WMSI) was significantly higher in the fQRS(+) group compared to the fQRS(-) group (P < 0.001). Multivariate analysis identified WMSI as an independent predictor of fQRS, while fQRS itself showed an inverse association with Left Ventricular Ejection Fraction (LVEF).
In-hospital complications and adverse events were notably more prevalent in patients with fQRS. The following table summarizes the comparative frequency of these clinical events:
| Clinical Event | Statistical Significance (P-value) |
|---|---|
| Advanced Heart Failure | P < 0.001 |
| In-hospital Reinfarction | P = 0.003 |
| Intraaortic Balloon Pump Use | P = 0.014 |
| Major Adverse Cardiovascular Events (MACE) | P = 0.024 |
Furthermore, the presence of fQRS at the time of admission was linked to a significant increase in long-term cardiovascular mortality (P = 0.028) and long-term all-cause mortality (P = 0.022).
Conclusion: The Link Between fQRS and Myocardial Injury
The study concludes that WMSI is significantly related to the presence of fQRS. This relationship reflects a critical link between the impairment of regional left ventricular systolic function and the severity of myocardial injury in STEMI patients. Consequently, fQRS serves as a vital indicator of both functional damage and long-term prognosis.
