Sakhnova T A, Blinova E V, Merkulova I N, Shakhnovich R M, Zhukova N S, Sukhinina T S, Barysheva N A, Staroverov I I
National Medical Research Center of Cardiology, Moscow, Russia.
Kardiologiia. 2021 Dec 31;61(12):22-30. doi: 10.18087/cardio.2021.12.n1896.
Aim To determine existence of a relationship between any clinical, echocardiographic and coronarographic factors and increased spatial QRS-T (sQRS-T) angle and frontal QRS-T (fQRS-T) angle in patients with anterior myocardial infarction.Material and methods This study included 137 patients aged 62 [53; 72] years with anterior acute myocardial infarction managed at the A.L. Myasnikov Institute of Clinical Cardiology. fQRS-T was calculated as the module of difference between the frontal plane QRS complex axis and the T wave axis. sQRS-T was calculated as a spatial angle between QRS and T integral vectors from a synthesized vectorcardiogram.Results fQRS-T values for a group (median [25th; 75th percentile]) were 81 [37; 120]°; sQRS-T values were 114 [80; 141]°. The correlation coefficient between fQRS-T and sQRS-T values was 0.41 (p<0.001). fQRS-T weakly but statistically significantly correlated with patients' age (r=0.28; p=0.001), left ventricular ejection fraction (LV EF, r= -0.22; p=0.01), and glomerular filtration rate (r=-0.32; p=0.0002). sQRS-T weakly but statistically significantly correlated with left ventricular end-diastolic dimension (r=0.24; p=0.0048), LV EF (r=-0.28; p=0.0009), and the number of affected segments according to echocardiography data (r=0.27; p=0.002). fQRS-T values were significantly higher in the presence of concurrent arterial hypertension. sQRS-T values were significantly higher in the presence of a history of chronic heart failure. Both fQRS-T and sQRS-T values increased with increasing number of affected blood vessels and Killip class of acute heart failure.Conclusion In patients after anterior acute myocardial infarction, increases in fQRS-T and sQRS-T are associated with more severe damage of the vasculature, decreased LV EF, and, thus, more severe clinical course of disease.
确定前壁心肌梗死患者的任何临床、超声心动图和冠状动脉造影因素与空间QRS-T（sQRS-T）角及额面QRS-T（fQRS-T）角增大之间是否存在关联。
本研究纳入了137例年龄为62[53；72]岁的前壁急性心肌梗死患者，这些患者在A.L.米亚斯尼科夫临床心脏病学研究所接受治疗。fQRS-T通过计算额面QRS波群电轴与T波电轴之间差值的模来得出。sQRS-T通过合成向量心电图中QRS波群与T波积分向量之间的空间角度来计算。
该组患者的fQRS-T值（中位数[第25；75百分位数]）为81[37；120]°；sQRS-T值为114[80；141]°。fQRS-T与sQRS-T值之间的相关系数为0.41（p<0.001）。fQRS-T与患者年龄（r=0.28；p=0.001）、左心室射血分数（LV EF，r=-0.22；p=0.01）以及肾小球滤过率（r=-0.32；p=0.0002）呈弱但具有统计学意义的相关性。sQRS-T与左心室舒张末期内径（r=0.24；p=0.0048）、LV EF（r=-0.28；p=0.0009）以及根据超声心动图数据得出的受累节段数量（r=0.27；p=0.002）呈弱但具有统计学意义的相关性。合并动脉高血压时fQRS-T值显著更高。有慢性心力衰竭病史时sQRS-T值显著更高。fQRS-T和sQRS-T值均随受累血管数量增加及急性心力衰竭Killip分级升高而增加。
在前壁急性心肌梗死后的患者中，fQRS-T和sQRS-T增大与血管系统更严重的损伤、LV EF降低相关，因此与更严重的临床病程相关。
