Analysis Of Electrocardiogram Characteristics In Patients With Three-vessel Disease

Objective: Coronary Atherosclerosis Heart Disease(CAD)has the characteristics as“high incidence,high morbidity,high mortality,high recurrence rate and more complications”.CAD is one of the most serious threats to patients' living quality and even lives at present.Triple-vessel coronary disease has become one of the most severe types of coronary atherosclerotic heart disease.With the constant population aging and life style changing,3-VD patients are increasing year by year.Because of its low survival rate,poor prognosis and atypical changes of electrocardiogram,it has always been a hot and difficult topic in the study of cardiovascular disease.Therefore we recorded and retrospectively analyzed the ECG features of 3-VD patients,explore the ECG characteristics of the 3-VD patients.By ECG findings reflect this kind of coronary vascular lesions,which provide the basis for the clinical diagnosis and treatment,so that physicians in clinical work can diagnose the disease faster and more accurate.Methods : From October 2013 to October 2015,84 patients with the diagnosis of triple-vessel coronary disease were selected in the hospital of Liao Ning Province after coronary angiography examination.Randomly selected no 3-VD patients(n=80)as a control group(all are NSTE-ACS,except lead a VR).Record patients' risk factors(include age;hypertension(above level 2);diabetes or abnormal glucose tolerance;obesity(BMI > 24Kg/m2);heart rate on admission;gender;smoking history;hypercholesterolemia and family history)and so on,analyze the ultrasonic cardiogram LVEF,onset electrocardiogram changes(ST-segment of lead a VR,QRS duration,Q wave and ST-T change).Results:(1)General risk factors General risk factors such as age,gender,diabetes or abnormal glucose tolerance,hypertension,hypercholesterolemia,family history,heart rate on admission,obesity(BMI>24Kg/ m2)between 3-VD patients and no3-VD patients have no statistically significant(P>0.05).(2)Number of the abnormal ECG leads Compared with no 3-VD patients,the average number of abnormal leads in 3-VD patients' is significantly increased.(1.6±1.393 vs 2.77±2.533,F=13.33426,P=0.01)(3)ECG ST-T changes 3-VD patients' electrocardiogram ST-T changes are significantly more than no 3-VD patients(53.6% vs 41.25%,P=0.038.3-VD patients' ST-T changes at anterior leads(V1-4,19.0% vs 16.25%,P=0.012)are significantly more than no 3-VD patients.While 3-VD patients' ST-T changes at lateral leads(I?a VL?V5 ? V6,19.0% vs 16.25%,P=0.17)and inferior leads(II?III ? a VF,17.9% vs 15.0%,P=0.09)and right ventricular leads(V3R-5R,9.52% vs7.5%,P=0.21)have no statistically significance with no 3-VD patients.In no 3-VD patients,coronary artery lesions are mostly seen at LCX(24,30%),secondly seen at RCA(22,27.5%),small vascular lesions and criminals' recanalization are the least seen(5,6.2%).(4)ECG lead aVR The number of patients with lead aVR ST-segment elevation in3-VD patients is significantly more than that in no 3-VD patients(35.7% vs 31.2%,P=0.045).In no 3-VD patients,lead a VR ST-segment elevation is most seen at LM lesions(n=3,3.6%).(5)ECG QRS duration Compare the number of patients with QRS duration wider between the 3-VD patients and the no 3-VD patients,the difference has statistical significance(33.3% vs 26.2%,P=0.033).(6)ECG Q wave Occurrence rate of Q wave between 3-VD patients and no 3-VD patients has no significantly variation(16.7 % vs 15.0%,P=1.34).Patients with Q wave have significant lower LVEF(52.13±10.51 vs 58.14±8.21,t=2.513,P=0.018).Patients with more than 4 Q wave have significant lower LVEF compared to patients with less than 4 Q wave(44.17±10.49 vs 55.13±8.41,t=4.431,P=0.002).No obvious abnormal ECG Compare the number of patients with no obvious abnormal ECGs between the 3-VD patients and the no 3-VD patients,the difference has statistical significance(41.7% vs 29.8%,X2=1.96,P=0.04).Conclusion:3-VD patients' ECG performance with more abnormal leads.Lead a VR ST-segment elevation,QRS duration widen and leads ST-T abnormal can be seen in3-VD patients.A number of 3-VD patients can also show normal ECGs.