入院心电图低QRS电压可预测前壁ST段抬高型心肌梗死的多支血管病变。
Low QRS Voltage on Presenting Electrocardiogram Predicts Multi-vessel Disease in Anterior ST-segment Elevation Myocardial Infarction.
作者信息
Kobayashi Akihiro, Misumida Naoki, Aoi Shunsuke, Kanei Yumiko
机构信息
Department of Internal Medicine, Mount Sinai Beth Israel, New York, USA.
Department of Internal Medicine, Mount Sinai Beth Israel, New York, USA.
出版信息
J Electrocardiol. 2017 Nov-Dec;50(6):870-875. doi: 10.1016/j.jelectrocard.2017.06.012. Epub 2017 Jun 8.
BACKGROUND
Low QRS voltage was reported to predict adverse outcomes in acute myocardial infarction in the pre-thrombolytic era. However, the association between low voltage and angiographic findings has not been fully addressed.
METHODS
We performed a retrospective analysis of patients with anterior ST-segment elevation myocardial infarction (STEMI). Low QRS voltage was defined as either peak to peak QRS complex voltage <1.0mV in all precordial leads or <0.5mV in all limb leads.
RESULTS
Among 190 patients, 37 patients (19%) had low voltage. Patients with low voltage had a higher rate of multi-vessel disease (MVD) (76% vs. 52%, p=0.01). Patients with low voltage were more likely to undergo coronary artery bypass grafting (CABG) during admission (11% vs. 2%, p=0.028). Low voltage was an independent predictor for MVD (OR 2.50; 95% CI 1.12 to 6.03; p=0.032).
CONCLUSION
Low QRS voltage was associated with MVD and in-hospital CABG in anterior STEMI.
背景
在溶栓治疗前的时代，有报道称低QRS电压可预测急性心肌梗死的不良结局。然而，低电压与血管造影结果之间的关联尚未得到充分探讨。
方法
我们对前壁ST段抬高型心肌梗死（STEMI）患者进行了回顾性分析。低QRS电压定义为所有胸前导联的QRS波群峰峰值电压<1.0mV或所有肢体导联的QRS波群峰峰值电压<0.5mV。
结果
在190例患者中，37例（19%）存在低电压。低电压患者的多支血管病变（MVD）发生率更高（76%对52%，p=0.01）。低电压患者在住院期间更有可能接受冠状动脉旁路移植术（CABG）（11%对2%，p=0.028）。低电压是MVD的独立预测因素（OR 2.50；95%CI 1.12至6.03；p=0.032）。
结论
在前壁STEMI中，低QRS电压与MVD及住院期间CABG相关。
Zotero 插件