The Relation Between The Distortion Of The Terminal Portion Of The QRS On The Electrocardiogram In Acute Myocardial Infarction And The Prognosis.

Objective:To determine the relationship between terminal QRS distortion and prognostic factors in acute myocardial infarction (AMI).Method:According to whether the terminal QRS distortion existed (47cases) (emergence of the J point≥50% of the R wave in leads with qR configuration,or disappearance of the S wave in leads with an Rs configur-ation) or not (113 cases), the initial electrocardiograms of 160 cases of AMI were divided into two groups. Patients with STEMI from the onset of symptoms to admission was less than 12h, hospital mortality were recorded in all patients. Meanwhile,these patients were followed up so as to evaluate their prognosis.Result:The incidence of terminal QRS distortion was found in about 30 percent of the cases. The mortality in hospital and incidence of cardiogenic shock and incidence of Killip class greater than II and incidence of adverse arrhythmia was significantly higher in the group with terminal QRS distortion than that without terminal QRS distortion (P<0.05). But the severity of coronary artery lesions evaluated by coronary angiogram were of no significant difference between the two groups. Multivariable logistic regres-sion analysis confirmed that hospital mortality was evidently associated with terminal QRS distortion (odds ratio 4.348,95% confidence interval 1.059 to 17.851, P=0.041) and admission Killip class (odds ratio 2.399,95% confidence interval 1.130 to 5.095, P=0.023).One-year mortality and incidence of reinfarction were higher (P=0.001) for patients with terminal QRS distortion of AMI compared with patients that without terminal QRS distortion. Conclusion:Terminal QRS distortion is one of the factors in predicting the bad prognosis in AMI.