Correlation Between Fragmented QRS Wave And Severity Of Coronary Artery In Acute Myocardial Infarction

Objective: Fragmented QRS wave(fQRS)is an easily evaluated and noninvasive electrocardiographic parameter.At present,many domestic and foreign studies have found that fQRS wave is of important reference value for the risk assessment and prognosis of coronary atherosclerotic heart disease,and is closely related to cardiac events in patients with coronary atherosclerotic heart disease(myocardial infarction,need for blood revascularization or cardiac death and death).The main purpose of our study is to study the correlation between the characteristics and severity of coronary lesions in patients with acute myocardial infarction and QRS,in order to provide a basis for the treatment,prognosis and prognosis of clinical diseases,and we also observe the correlation between the fragmentation of QRS waves and the severity of coronary lesions in acute myocardial infarction.Methods: The clinical diagnosis of acute myocardial infarction(AMI)in the Department of Cardiology of the people's Hospital of Xinjiang autonomous region from January 2016 to August 2017 was retrospectively analyzed,and 196 patients were diagnosed by coronary angiography.The patients were divided into two groups according to acute ST segment elevation myocardial infarction(STEMI)and acute non ST segment elevation myocardial infarction(NSTEMI),and then acute ST segment elevation myocardial infarction(STEMI)and acute non ST elevation myocardial infarction(NSTEMI)were divided into fQRS wave group and non fQRS wave group respectively.The general clinical data of the two groups(including age,sex,smoking history,body mass index)were compared.The severity of fQRS and coronary artery disease was analyzed with hypertension,diabetes,and hyperlipidemia.The severity of coronary lesions was evaluated by SYNTAX score and Gensini score.The severity of coronary lesions in the fQRS and non fQRS groups was compared,and the severity of coronary lesions was compared with the number of lead in fQRS.Results:(1)There were no significant differences in age,high sensitive C reactive protein S-CRP(mg/L),low density lipoprotein LDL-C(mmol/L),triglyceride TG(mmol/L),hypertension history,diabetes history,smoking history and family history in patients with acute ST segment elevation myocardial infarction(STEMI)and acute non ST segment elevation myocardial infarction(NSTEMI).(2)There were 97 cases of acute ST segment elevation myocardial infarction(STEMI),41 cases in fQRS wave group(42.26%),99 cases of acute non ST elevation myocardial infarction(NSTEMI),31 cases in fQRS wave group(31.31%),and larger left ventricular end diastolic diameter(LVEDD)in fQRS wave group,lower left ventricular ejection fraction(LVEF),BNP level higher,cTn I and CK-MB level was also higher(P<0.05),fQRS wave group Gensini score and SX score were higher(P<0.05).(3)The left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and BNP level were higher in the fQRS > 3 lead group than in the fQRS<3 lead group(P<0.05),and the Gensini score and the SX score were also higher(P<0.05).(4)The incidence of QRS wave in the anterior descending,left circumflex and right coronary artery lesions was 77.78%,63.83%,68.05%,and the difference was statistically significant(P<0.05).(5)The incidence of multiple vascular lesions(MVD)was higher than that of the fQRS<3 lead group(61.9%vs15.6%,P <0.05),and the incidence of coronary artery chronic complete occlusion(CTO)in patients with fQRS more than 3 was higher than The QRS<3 lead group(23.8% vs 5.9%,P<0.05).Conclusion: 1.Patients with acute myocardial infarction with fragmented QRS wave had more severe coronary lesions.2.The more the number of leads that the fragmentation QRS wave appeared on the body surface ECG,the more serious the coronary lesions were.3.Fragmentation QRS wave was found in the anterior descending group.4.The more fractured QRS waves appear in the guide,suggesting that the possibility of coronary multiple vessel disease(MVD)and chronic complete occlusion of coronary artery(CTO)is more likely.