A Study Of The Correlation Between FQRS Wave And The Formation Of Collateral Circulation In Acute STEMI Patients With Selective PCI

Objective: To investigate the correlation between f QRS wave and early collateral circulation(CCC)in patients with acute ST segment elevation myocardial infarction undergoing elective percutaneous transluminal coronary angioplasty.Methods:This retrospective analysis from January 2014 to July 2017 in the Department of Cardiology of Shengjing Hospital affiliated to China Medical University from 156 cases of acute ST patients undergoing percutaneous coronary artery stenting segment elevation myocardial infarction,according to the Rentrop classification method to assess the collateral circulation(CCC),the patients were divided into group of no collateral circulation group(grade 0,the number of cases is85)and a collateral circulation group(grade 1 、 grade 2 and grade 3,the number of cases is 71);The f QRS was defined as the presence of an additional R wave or notching of R or S wave or the presence of fragmentation in two contiguous electrocardiogram leads corresponding to a major coronary artery territory.The clinical data of two groups of patients,coronary angiography and other coronary angiography results and f QRS wave results were compared;multivariate analysis of the correlation with the collateral circulation;further based on the number of f QRS waveguide grouping In comparison,the number of leads was analyzed for differences in the formation of collateralcirculation.Results:1.Thecomparisonbetweenthetwogroups: thecollateralcirculationgroup had longer onset time to PCI than the non-collateral circulation group,and the left ventricular ejection fraction was higher,the difference was statistically significant,P<0.05.The number of f QRS waveguides and f QRS waveguides in collateral circulation group and collateral circulation group was significantly different(P<0.05)..2.In a group with or without collateral circulation,a comparison of the position of f QRS waveguides: the detection rate of f QRS waves in the collateral circulation was as high as 54.9%;in the group with collateral circulation,f QRS occupied 22.5% in the V1-V5 lead and 10.6% in the V1-V5 lead without collateral circulation group;the two group had a comparative statistical significance(P=0.045);in the group of collateral branches,there was collateral circulation.in the collateral circulation group,f QRS accounted for 32.4% of the II,III,a VF or I,a VL leads.In the no collateral circulation group,28.2% of f QRS were found in lead II,III,a VF or I,a VL,and there was no significant difference between the two groups(P=0.603)。3.In the group with or without f QRS waves,poor collateral circulation formation was compared with good: in the f QRS wave group,collaterals Patients with poor circulation(CCC0 or CCC1)accounted for 68.1%.In the non-f QRS wave group,86.9%of patients with poor collateral circulation(CCC0 or CCC1)had no statistically significant difference(P=0.121);A good group of branches(CCC2 or 3)accounted for 31.9%.In the non f QRS wave group,the good group of collateral branches(CCC2or CCC3)accounted for 13.1%,and there was a significant difference between the two groups(P=0.006).In the group with or without f QRS waves,poor collateral circulation formation was compared with good: in the f QRS wave group,collaterals Patients with poor circulation(CCC0 or CCC1)accounted for 68.1%.In the non-f QRS wave group,86.9% of patients with poor collateral circulation(CCC0 or CCC1)had no statistically significant difference(P=0.121);In the f QRS group,31.9%of the patients in the good collateral circulation group(CCC2 or 3),and 13.1% in the good collateral circulation group(CCC2 or CCC3)in the non-f QRS wave group,and there was significant difference between the two groups(P=0.006)。Conclusion:1.In patients with acute ST-segment elevation myocardial infarction undergoing elective percutaneous coronary intervention,the presence of acute anterior wall myocardial infarction(V1-V5)f QRS waves may be associated with good collateral circulation formation;2..In patients with acute ST-segment elevation myocardial infarction undergoing elective percutaneous coronary intervention,the presence of f QRS waves in acute inferior wall or lateral wall myocardial infarction(Ⅱ,Ⅲ,a VF,or Ⅰ,a VL)and the formation of collateral circulation are not obvious correlation.