碎裂QRS与冠状动脉病变功能意义之间的关系。

The relationship between fragmented QRS and functional significance of coronary lesions.

作者信息

Korkmaz Ahmet, Yildiz Abdulkadir, Demir Mevlut, Ozyazgan Burcu, Sahan Ekrem, Acar Burak, Guray Umit, Ileri Mehmet, Elalmis Ozgul Ucar

机构信息

Ankara Numune Training and Research Hospital, Department of Cardiology, Ankara, Turkey.

Bezmialem Vakif University Hospital, Department of Cardiology, Istanbul, Turkey.

出版信息

J Electrocardiol. 2017 May-Jun;50(3):282-286. doi: 10.1016/j.jelectrocard.2017.01.005. Epub 2017 Jan 15.

DOI:10.1016/j.jelectrocard.2017.01.005

PMID:28117101

Abstract

BACKGROUND

Recently fragmented QRS (fQRS) on electrocardiography (ECG) has been introduced as a predictor of myocardial scarring and myocardial ischemia in coronary artery disease (CAD).

OBJECTIVE

The aim of this study was to investigate the relationship between fQRS and fractional flow reserve (FFR) results in patients with the intermediate degree of coronary artery stenosis.

METHODS

A total of 301 consecutive patients who underwent coronary angiography (CAG) and FFR measurement for intermediate coronary artery stenosis were included in the study. The study patients were divided into two groups: the low FFR group (FFR value of ≤0.80) and normal FFR (FFR value of >0.80) group. Both groups were compared in terms of the presence of fQRS.

RESULTS

Of 301 patients, fQRS was detected in 128 (42.5%) and low FFR was detected in 115 (38.2%). In the low FFR group, fQRS was significantly higher (P<0.001). Multivariate analysis showed that fQRS was an independent predictor of myocardial ischemia in patients with intermediate coronary stenosis (OR=7.202, CI 95%, 4.195-12.367; p<0.001). The presence of fQRS had 70% sensitivity and 74% specificity for the prediction of FFR≤0.80.

CONCLUSION

In clinical practice, the presence of fQRS on ECG is associated with myocardial ischemia in patients with intermediate coronary stenosis.

摘要

背景

心电图（ECG）上近期出现的碎裂QRS波（fQRS）已被引入作为冠状动脉疾病（CAD）中心肌瘢痕形成和心肌缺血的预测指标。

目的

本研究旨在探讨冠状动脉中度狭窄患者中fQRS与血流储备分数（FFR）结果之间的关系。

方法

本研究共纳入301例因冠状动脉中度狭窄接受冠状动脉造影（CAG）和FFR测量的连续患者。研究患者分为两组：低FFR组（FFR值≤0.80）和正常FFR组（FFR值>0.80）。比较两组fQRS的存在情况。

结果

301例患者中，128例（42.5%）检测到fQRS，115例（38.2%）检测到低FFR。在低FFR组中，fQRS显著更高（P<0.001）。多变量分析显示，fQRS是冠状动脉中度狭窄患者心肌缺血的独立预测指标（OR=7.202，95%CI，4.195-12.367；p<0.001）。fQRS的存在对预测FFR≤0.80具有70%的敏感性和74%的特异性。