Relationship Study Between Fragmented QRS Complex And The Severity Of Coronary Artery Lesion In Patients With Coronary Artery Disease

Objective To research the relationship between fragmented QRS complex(fQRS) and the severity of coronary artery lesion in patients with coronary artery disease(CAD).Methods We collected patients hospitalized in the Affliated Hospital of Medical College of Guilin Heart Medical during 1 September,2007 to 1September 2009,and accepted resting ECG surface,coronary angiography,cardiac color Doppler echocardiography,Blood biochemical and other related inspection when they hospitalized in our hospital,exclusion out criteria in accordance with the corresponding rule of the possibility of interference caused by a variety of possible cases,the retrospective analysis of 292 cases of the remaining patients.Coronary angiography in the diagnosis of myocardial ischemia as a gold standard, 292 cases were grouped according to the presence with or without fQRS. The degree of stenosis and extent of lesions, and collateral circulation were analysesed and compared between the patients with or without fQRS.Results⑴.The extent of lesions was higher in patients with fQRS than that of the patients without fQRS(P < 0.05). The rates of three vessle desease in patients with fQRS group was 48.85%, significantly higher than that in without fQRS ( 23.73%).But the rates of double and single vessle desease in patients with fQRS group (31.61% and 19.54%,respectively) lower than that of the patients without fQRS (33.05% and 43.22%,respectively).⑵.The culprit vessel incidence rate of left circumflex artery and right coronary artery in patients with fQRS group (42.53% and 33.76% ,respectively),significantly higher than that in without fQRS (20.34% and 33.05%,respectively()P < 0.05) . The culprit vessel incidence rate of left anterior descending coronary artery in patients with fQRS group (was 24.1%) lower than that of the patients without fQRS (46.61%)(P > 0.05). Considering the left anterior descending coronary artery as the main branch vessel, the culprit vessel thrombolysis more timely,or due to the thrombus autolyzed or obstructed in distal segment and branch vessels.⑶.The subocclusion lesion incidence rate was higher in patients with fQRS than that of the patients without fQRS(P < 0.05). The rates of >90% stenosis in patients with fQRS group was 41.95%, significantly higher than that in without fQRS ( 27.12%).But occlusion lesion incidence rate was lower in patients with fQRS than that of the patients without fQRS. That is, when occlusion lesion were happened in coronary arteries ,the incidence rate with"islands"of viable myocardial tissue probable low(P > 0.01).⑷.The incidence rate of collateral circulation in patients with fQRS group was 38.51%, significantly higher than that in without fQRS ( 14.41%) ( P<0.01) .⑸.Fragmented QRS complex as a diagnosis of lesions in coronary heart disease target,their specificities are the sam(e75.22% :58.51%:40.00%), The sensitivity and negative predictive value of three vessle disease in patients with fQRS group were significantly higher than that in double vessle disease and single vessel disease (respectively 75.22%:58.51%:40.00% and 65.00%:57.14%:50.49%) .Conclusions The fragmented QRS complex appear in the surface ECG of in coronary heart disease patients can lead the corresponding stenosis and lesions region of coronary artery, It can be an additive predictor of the degree of stenosis and extent of lesions with coronary artery disease.