Dehghani Mohammad Reza, Baradaran Mansoureh, Rostamzadeh Alireza, Masudi Sima, Aghamiri Amin, Hajizadeh Reza
Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
Department of Biostatistics and Epidemiology, Urmia University of Medical Sciences, Urmia, Iran.
Caspian J Intern Med. 2024 Oct 19;16(1):83-89. doi: 10.22088/cjim.16.1.83. eCollection 2025 Winter.
Acute pulmonary embolism can quickly cause hemodynamic collapse and death. Recent studies have shown that different characteristics of electrocardiogram (ECG) can be used to predict the prognosis of patients. This study aimed to investigate the relative frequency of fragmented QRS in the ECG of patients with pulmonary embolism and its prognostic value.
This study was conducted retrospectively. The files of 106 patients hospitalized with a diagnosis of pulmonary embolism from January 2016 to the end of March 2020 were selected and reviewed. The findings of the ECG, including the ST elevation in V1-V4 leads with and without T invention, right axis deviation, right bundle branch block (RBBB), PR, QRS, QTc intervals, type of treatment (thrombolysis or embolectomy), cardiogenic shock, mortality were collected. Finally, the data were recorded and analyzed in SPSS software Version 16
Hypertension, dyslipidemia, and diabetes mellitus were the most frequent risk factors among the patients. The relative frequency of fragmented QRS, at least in one lead, was 26.2%. The use of thrombolysis, mechanical ventilation, embolectomy, cardiogenic shock, and in-hospital death was significantly higher among patients who had fragmented QRS (P<0.001). CTNI was significantly higher in patients with fragmented QRS (P=0.001). In patients with fragmented QRS large vessels, involvement was significantly higher.
This study showed that the presence of fragmented QRS in the ECG of acute embolism patients has a significant relationship with cardiogenic shock, hospital mortality, and the need for advanced treatment methods such as intubation, embolectomy, and the use of thrombolysis.
急性肺栓塞可迅速导致血流动力学崩溃和死亡。近期研究表明，心电图（ECG）的不同特征可用于预测患者的预后。本研究旨在调查肺栓塞患者心电图中碎裂QRS波的相对频率及其预后价值。
本研究为回顾性研究。选取2016年1月至2020年3月底确诊为肺栓塞住院的106例患者的病历进行回顾。收集心电图检查结果，包括V1-V4导联有无T波倒置时的ST段抬高、电轴右偏、右束支传导阻滞（RBBB）、PR间期、QRS间期、QTc间期、治疗类型（溶栓或栓子切除术）、心源性休克、死亡率。最后，将数据记录并在SPSS 16.0软件中进行分析。
高血压、血脂异常和糖尿病是患者中最常见的危险因素。至少在一个导联出现碎裂QRS波的相对频率为26.2%。有碎裂QRS波的患者使用溶栓、机械通气、栓子切除术、心源性休克和院内死亡的比例显著更高（P<0.001）。有碎裂QRS波的患者肌钙蛋白I（CTNI）显著更高（P=0.001）。有碎裂QRS波的患者大血管受累显著更高。
本研究表明，急性肺栓塞患者心电图中存在碎裂QRS波与心源性休克、医院死亡率以及插管、栓子切除术和溶栓等高级治疗方法的需求有显著关系。
