Asadi Anar Mahsa, Ansari Akram, Erabi Gisou, Rahmanian Mohammad, Movahedi Mahdiyeh, Chichagi Fatemeh, Deravi Niloofar, Taghavi Farid, Kazemi Babak, Javanshir Elnaz, Amouei Erfan, Ghaffari Samad
Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences Tehran, Iran.
Medical Student, Shantou University Medical College Shantou, Guangdong, China.
Am J Cardiovasc Dis. 2023 Feb 15;13(1):21-28. eCollection 2023.
Acute Pulmonary embolism (APE) is considered one of the deadliest cardiovascular diseases. Electrocardiographic (ECG) abnormalities in pulmonary embolism (PE) are increasingly reported. A growing number of studies have recommended that ECG plays a crucial role in the prognostic assessment of PE patients. However, there is scarce data on the prognostic importance of fragmented QRS (fQRS) on outcomes in patients with APE. This study aims to investigate the prognostic value of fQRS in APE patients.
This is a cross-sectional-analytic study. This study included 280 patients diagnosed with APE admitted to Shahid Madani hospital, Tabriz, Iran. Computed tomography pulmonary angiography (CTPA) was used to diagnose APE. A checklist was prepared for all patients, demographic, clinical characteristics, and Major Adverse Cardiopulmonary events (MACPE), including in-hospital mortality, need for thrombolysis, mechanical ventilation, and surgical embolectomy, were recorded. Patients were divided into two groups: patients who manifested fQRS on their ECG and patients who did not; Then, demographic, clinical characteristics, and MACPE were compared in the two groups, as mentioned earlier. Furthermore, all statistical analyses were carried out using SPSS software.
48 patients (17.14%) had fQRS(+) on their ECG, and 232 patients (82.86%) did not have it on their ECG. In data analysis, 22 patients (8.7%) had in-hospital mortality, 35 patients (13.9%) needed thrombolysis, nine patients (3.9%) required mechanical ventilation, and 13 patients (5.1%) needed surgical embolectomy. fQRS was not significantly associated with in-hospital mortality (P = 0.225), need for thrombolysis (P = 0.684), mechanical ventilation (P = 1.000), and surgical embolectomy (P = 1.000). Demographic and clinical characteristics were also similar in both groups.
This study does not support the idea that fQRS on ECG is a valuable predictor of in-hospital mortality, the need for thrombolysis, mechanical ventilation, and surgical embolectomy.
急性肺栓塞（APE）被认为是最致命的心血管疾病之一。越来越多的研究报告了肺栓塞（PE）患者的心电图（ECG）异常情况。越来越多的研究建议，心电图在PE患者的预后评估中起着至关重要的作用。然而，关于碎裂QRS波（fQRS）对APE患者预后的重要性的数据却很少。本研究旨在探讨fQRS在APE患者中的预后价值。
这是一项横断面分析研究。本研究纳入了280例在伊朗大不里士的沙希德·马达尼医院确诊为APE的患者。采用计算机断层扫描肺动脉造影（CTPA）诊断APE。为所有患者准备了一份清单，记录了人口统计学、临床特征以及主要心肺不良事件（MACPE），包括住院死亡率、溶栓需求、机械通气需求和外科取栓术需求。患者被分为两组：心电图显示fQRS的患者和未显示fQRS的患者；然后，如前所述，比较两组患者的人口统计学、临床特征和MACPE。此外，所有统计分析均使用SPSS软件进行。
48例患者（17.14%）心电图显示fQRS（+），232例患者（82.86%）心电图未显示fQRS。在数据分析中，22例患者（8.7%）有住院死亡率，35例患者（13.9%）需要溶栓，9例患者（3.9%）需要机械通气，13例患者（5.1%）需要外科取栓术。fQRS与住院死亡率（P = 0.225）、溶栓需求（P = 0.684）、机械通气需求（P = 1.000）和外科取栓术需求（P = 1.000）均无显著相关性。两组患者的人口统计学和临床特征也相似。
本研究不支持心电图上的fQRS是住院死亡率、溶栓需求、机械通气需求和外科取栓术需求的有价值预测指标这一观点。
