Correlation Analysis of Electrocardiogram fQRS Wave With the Extent and Degree of Coronary Lesions in Acute Myocardial Infarction
Objective To explore the correlation between fragmented QRS complex (fQRS) wave on electrocardiogram and the range and degree of coronary artery disease in patients with acute myocardial infarction (AMI). Methods A total of 80 AMI patients admitted to Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from January to December 2023 were selected. They were divided into non fQRS group (n=48) and fQRS group (n=32) based on the presence or absence of fQRS waves on the electrocardiogram. General information of the two groups of patients was analyzed,and left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diamete (LVEDd) levels were collected by ultrasound examination. Coronary angiography was used to evaluate the number of coronary lesion range,stenosis degre,and diseased vessel in the patients,the Gensini score of coronary angiography was detected and compared,and the Spearman correlation coefficient was used to analyze the correlation between fQRS wave and the extent and severity of coronary artery disease. For patients with AMI,a multivariable Cox proportional hazards model (Cox) was used to identify risk factors associated with adverse cardiovascular events. Results The incidence of hypertension,diabetes,adverse cardiovascular events and LVEDd in fQRS group were higher than those in non FQRS group,and LVEF was lower than that in non FQRS group (P<0.05). fQRS group had higher coronary lesion range,stenosis degree and Gensini score than non FQRS group (P<0.05). Pearson correlation analysis showed that fQRS waves were positively correlated with hypertension,diabetes,adverse cardiovascular events,LVEDd,coronary lesion range (double and multiple vessel lesions),stenosis degree (moderate to severe stenosis) and Gensini score (r=0.233,0.310,0.275,0.559,0.345,0.386,0.660,P<0.05),fQRS waves were negatively correlated with LVEF (r=-0.634,P<0.001). Cox analysis of AMI patients showed that hypertension,diabetes,LVEDd,lesion scope (double and multiple vessel lesions),stenosis degree (moderate to severe stenosis),fQRS wave and Gensini score were all risk factors for cardiovascular adverse events in AMI patients (P<0.05). LVEF was considered a protective factor in this patient population (P<0.05). The hazard ratio (HR) of fQRS as an independent predictor was 2.695 (95％CI 1.487 to 3.857). Conclusion fQRS waves are common in AMI patients and are related to the extent and severity of coronary artery lesions. This factor is considered to be significantly independent in predicting adverse cardiovascular events,and has important value in clinical application,which can assist medical personnel to develop more effective pre-treatment strategies and improve patient prognosis.
acute myocardial infarctionthe range of coronary lesionsfQRS waveGensini scoreleft ventricular end-diastolic diameteadverse cardiovascular events
万方数据
维普
