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
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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.
