Relationship of Admission QRS Duration and Changes in QRS Duration With Myocardial Reperfusion in Patients With Acute ST Segment Elevation Myocardial Infarction (STEMI) Treated With Fibrinolytic Therapy

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概要

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• Background Although ischemia induced QRS complex changes have been described previously, their relationship with impaired reperfusion, which is known to be associated with poor clinical outcomes, is not clear. Methods and Results To investigate the relationship of QRS duration changes with myocardial reperfusion, we studied 165 acute myocardial infarction (MI) patients who were administered fibrinolytic therapy for reperfusion. For each patient, 12-lead electrocardiogram (ECG) with a paper speed of 50mm/s was recorded on admission and repeated at the 60^<th> and 90^<th> min following fibrinolytic therapy. Based on the myocardial blush grades obtained from a control coronary angiography, patients were divided into reperfusion (grades 2, 3) and impaired reperfusion (grades 0, 1) groups. We detected impaired reperfusion in 74 patients. The patients in the impaired reperfusion group were older, more often diabetic, and had longer pain-to-needle intervals. They also had significantly longer QRS durations at admission compared to reperfusion group patients (91±11 vs 79±11ms, p<0.001). Reperfusion group patients showed significantly greater resolution in QRS duration at the 90^<th> min post fibrinolysis ECG (18±5 vs 5±4ms, p<0.001). In regression analysis, the pain-to-needle time (odds ratio (OR): 0.55, 95% confidence interval (CI) 0.35-0.88, p=0.012), QRS duration on admission (OR: 0.80, 95% CI 0.67-0.97, p=0.021), and change in QRS duration at the post fibrinolysis 90^<th> min ECG (OR: 2.43, 95% CI, 1.29-4.60, p=0.006) were determined as independent predictors of adequate reperfusion. Conclusion The present study, for the first time, has shown that admission QRS duration and post fibrinolysis 90^<th> min QRS duration changes are related to tissue reperfusion in fibrinolytic administered acute MI patients.

• 2008-05-20

著者

• Ulusoy Vasfi

  Cardiology Department Ankara Numune Education And Research Hospital

• Maden Orhan

  Cardiology Department Yuksek Ihtisas Education And Research Hospital

• Selcuk Hatice

  Cardiology Department Yuksek Ihtisas Education And Research Hospital

• Kacmaz Fehmi

  Cardiology Department, Yuksek Ihtisas Education and Research Hospital

• Celebi Savas

  Cardiology Department, Ankara Numune Education and Research Hospital

• Ureyen Cagin

  Cardiology Department, Ankara Numune Education and Research Hospital

• Alyan Omer

  Cardiology Department, Faculty of Medicine, Dicle University

• Erbay Ali

  Cardiology Department, Yuksek Ihtisas Education and Research Hospital

• Balbay Yucel

  Cardiology Department, Yuksek Ihtisas Education and Research Hospital

• Ilkay Erdogan

  Cardiology Clinic, Mesa Hospital

• Erbay Ali

  Cardiology Department Yuksek Ihtisas Education And Research Hospital

• Alyan Omer

  Cardiology Department Faculty Of Medicine Dicle University

• Kacmaz Fehmi

  Cardiology Department Yuksek Ihtisas Education And Research Hospital

• Celebi Savas

  Cardiology Department Ankara Numune Education And Research Hospital

• Balbay Yucel

  Cardiology Department Yuksek Ihtisas Education And Research Hospital

• Ureyen Cagin

  Cardiology Department Ankara Numune Education And Research Hospital

• Ilkay Erdogan

  Cardiology Clinic Mesa Hospital

関連論文

• Relationship of Admission QRS Duration and Changes in QRS Duration With Myocardial Reperfusion in Patients With Acute ST Segment Elevation Myocardial Infarction (STEMI) Treated With Fibrinolytic Therapy
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