急性心肌梗死患者QRS波时限延长与冠状动脉侧支循环存在之间的关联。
The association between prolongation in QRS duration and presence of coronary collateral circulation in patients with acute myocardial infarction.
作者信息
Karahan Zülküf, Altıntaş Bernas, Uğurlu Murat, Kaya İlyas, Uçaman Berzal, Uluğ Ali Veysel, Altındağ Rojhat, Altaş Yakup, Adıyaman Mehmet Şahin, Öztürk Önder
机构信息
Gazi Yasargil Education and Research Hospital, Turkey.
出版信息
JRSM Cardiovasc Dis. 2016 Jul 4;5:2048004016657475. doi: 10.1177/2048004016657475. eCollection 2016 Jan-Dec.
BACKGROUND
It is known that QRS duration is related to prognosis in acute myocardial infarction. The relation between QRS duration and coronary collateral circulation is uncertain. In the present study, we aimed to determine the relation between QRS duration and coronary collateral circulation in patients admitted with acute myocardial infarction.
METHODS
The present study was composed of 109 consecutive patients with acute myocardial infarction. All patients had total occlusion in the left anterior descending coronary artery. Electrocardiographic recordings on admission were obtained for the assessment of QRS duration. The Rentrop classification was used to define coronary collateral circulation on coronary angiography. Patients were divided into two groups as follows: Group 1 with poor coronary collateral circulation (Rentrop 0-1) and Group 2 with good coronary collateral circulation (Rentrop 2-3).
RESULTS
Of all patients, 62 patients were included in group 1 and 47 patients in group 2, respectively. In the present study, patients in the group 1 had longer QRS duration than patients in the group 2 (p < 0.005). Additionally, we found that Rentrop grading had negative correlation with both QRS duration and white blood cell count (r: -0.28; p < 0.005 and r: -0.35; p < 0.001).
CONCLUSION
Our study showed that there was an inverse relationship between QRS duration on admission and presence of coronary collateral circulation in patients with acute myocardial infarction.
背景
已知QRS波时限与急性心肌梗死的预后相关。QRS波时限与冠状动脉侧支循环之间的关系尚不确定。在本研究中，我们旨在确定急性心肌梗死患者QRS波时限与冠状动脉侧支循环之间的关系。
方法
本研究纳入109例连续的急性心肌梗死患者。所有患者左前降支冠状动脉完全闭塞。入院时进行心电图记录以评估QRS波时限。采用Rentrop分级在冠状动脉造影时定义冠状动脉侧支循环。患者分为以下两组：1组冠状动脉侧支循环不良（Rentrop 0 - 1级）和2组冠状动脉侧支循环良好（Rentrop 2 - 3级）。
结果
所有患者中，分别有62例纳入1组，47例纳入2组。在本研究中，1组患者的QRS波时限长于2组患者（p < 0.005）。此外，我们发现Rentrop分级与QRS波时限和白细胞计数均呈负相关（r： - 0.28；p < 0.005和r： - 0.35；p < 0.001）。
结论
我们的研究表明，急性心肌梗死患者入院时的QRS波时限与冠状动脉侧支循环的存在呈负相关。
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