Eyuboglu Mehmet, Kucuk Ugur, Senarslan Omer, Akdeniz Bahri
Department of Cardiology, Avrupa Medicine Center, Karabaglar, Izmir, Turkey.
Department of Cardiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
Rev Port Cardiol. 2017 Feb;36(2):89-93. doi: 10.1016/j.repc.2016.07.008. Epub 2017 Jan 30.
Fragmented QRS complexes (fQRS) are a sign of myocardial scar and are associated with adverse outcomes and mortality in patients with coronary artery disease (CAD). However, little is known about the significance of fQRS or of their localization on electrocardiography (ECG) in patients without known CAD. We aimed to investigate the association between localization of fQRS on ECG and CAD severity in patients undergoing a first diagnostic coronary angiography.
We enrolled 135 consecutive patients who had a narrow fQRS on ECG and underwent a first diagnostic coronary angiography. Patients were divided into two groups based on localization of fQRS on ECG (group 1: fQRS in the inferior leads, group 2: fQRS in the anterior leads). The groups were compared regarding the presence of significant CAD, multivessel disease (MVD) and SYNTAX score (SXscore).
Eighty-six (63.7%) patients had fQRS in the inferior leads and 49 (36.3%) had fQRS in the anterior leads. There was no statistically significant difference between the groups regarding presence of significant CAD (47.7% vs. 51%, p=0.708). However, the incidence of MVD was significantly higher in group 2 compared to group 1 (10.5% vs. 28.6%, p=0.007). The median SXscore (6 [3,12] vs. 8 [4,24], p=0.047), and incidence of patients with SXscore >22 were significantly higher in group 2 compared to group 1 (3.5% vs. 20.4%, p=0.009).
The presence of fQRS in the anterior leads may indicate more severe CAD compared to fQRS in the inferior leads in patients undergoing a first diagnostic coronary angiography.
碎裂QRS波群（fQRS）是心肌瘢痕的一种表现，与冠状动脉疾病（CAD）患者的不良预后及死亡率相关。然而，对于无已知CAD患者，fQRS的意义或其在心电图（ECG）上的定位了解甚少。我们旨在研究首次诊断性冠状动脉造影患者中，ECG上fQRS的定位与CAD严重程度之间的关联。
我们纳入了135例ECG上有窄fQRS且接受首次诊断性冠状动脉造影的连续患者。根据ECG上fQRS的定位将患者分为两组（1组：下壁导联出现fQRS，2组：前壁导联出现fQRS）。比较两组患者显著CAD、多支血管病变（MVD）及SYNTAX评分（SXscore）的情况。
86例（63.7%）患者下壁导联出现fQRS，49例（36.3%）患者前壁导联出现fQRS。两组患者显著CAD的存在情况无统计学显著差异（47.7%对51%，p = 0.708）。然而，2组MVD的发生率显著高于1组（10.5%对28.6%，p = 0.007）。2组的SXscore中位数（6 [3,12]对8 [4,24]，p = 0.047）以及SXscore>22的患者发生率显著高于1组（3.5%对20.4%，p = 0.009）。
在接受首次诊断性冠状动脉造影的患者中，与下壁导联出现fQRS相比，前壁导联出现fQRS可能提示CAD更严重。
