Fragmented QRS complex is a prognostic marker of microvascular reperfusion and changes in LV function occur in patients with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention

Zhang, Ruoxi; Chen, Shuyuan; Zhao, Qi; Sun, Mingshu; Yu, Bo; Hou, Jingbo

doi:10.3892/etm.2017.4380

Cited by 16 publications

(16 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent studies have shown that fQRS may be of significant prognostic value in patients with STEMI undergoing reperfusion therapy 6, 7, 8, 9, 10. STEMI patients with fQRS in electrocardiogram (ECG) tend to have higher cardiac biomarker levels, higher inflammatory markers, higher angina to balloon time, lower left ventricular function, extensive coronary artery involvement, and poorer reperfusion parameters 11, 12, 13.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of fragmented QRS in patients with ST-elevation myocardial infarction undergoing revascularization

Umapathy

Yadav

Goswami

et al. 2018

Indian Heart Journal

View full text Add to dashboard Cite

Background & ObjectivesThis longitudinal study was carried out to evaluate the prognostic significance of fragmented QRS (fQRS) in patients with acute ST elevation myocardial infarction (STEMI) undergoing revascularization.MethodsThis study included 103 STEMI patients belonging to Killip class I and II who underwent primary revascularization. All patients underwent twelve lead ECG at admission before PCI. Serial ECG were done after PCI at 3 hours, 6 hours, 24 hours, 48 hours and at discharge for detection of fQRS and echocardiography on day 3 post revascularization. Patients developing fQRS within 48 hours and with persistence of fQRS till discharge were included in “persistent fQRS” group. They were followed up after 30 days for major adverse cardiac events (MACE) and assessment of LV function by echocardiography.ResultsfQRS was present in 64 patients (61.5%) of study population with 37 patients (57.8%) having persistent fQRS. MACE rates were low (4.8%) and did not differ with respect to fQRS. fQRS significantly correlated with LV dysfunction at 30 days on univariate analysis (p-0.003) but not on multivariate analysis (p -0.10). fQRS was significantly related to impaired myocardial reperfusion as assessed by ΣSTR (percent of total ST segment resolution) (adjusted odds ratio, 95% CI [4.265 (1.034 – 17.58)], p = 0.04).ConclusionIn our study, fQRS did not predict MACE and LV dysfunction in acute STEMI patients belonging to Killip class I and II on short term follow-up of 30 days. But, fQRS independently predicted impaired microvascular myocardial reperfusion as assessed by ΣSTR.

show abstract

Section: Introductionmentioning

confidence: 99%

Prognostic significance of fragmented QRS in patients with ST-elevation myocardial infarction undergoing revascularization

Umapathy

Yadav

Goswami

et al. 2018

Indian Heart Journal

View full text Add to dashboard Cite

show abstract

“…These forms occur as a result of non-homogeneous electrical activation of either ischemic injured ventricular myocardium or myocardial scar. [14] Many investigators had reported the significant association between the presence of fQRS and the short-term and long outcome and mortality in STEMI patients [15][16][17] However, our study was conducted on non ST-segment elevation acute coronary syndrome patients. In patients with various presentations of IHD, the presence of fQRS was associated with myocardial scarring.…”

Section: Discussionmentioning

confidence: 99%

“…Despite their similar clinical presentations and treatment strategies, Puelacher and his colleagues have found that all-cause mortality was significantly higher in patients with NSTEMI compared with UA patients despite of similar incidence of future non-fatal myocardial infarction was comparable between the two groups. [17] So, it seems that early detection of NSTEMI among patients with acute coronary syndrome might be useful. The standard method of differentiation between NSTEMI and UA is measuring of cardiac biomarkers and the most important and widely used in practice is the high-sensitivity cardiac troponin (hscTn) [7,8] However, there is a lag time hscTn between the beginnings of symptoms of NSTEMI to the rise of hscTn to a level that could diagnose NSTEMI.…”

Section: Discussionmentioning

confidence: 99%

Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome

Radwan¹,

Mansour²,

Al-Daydamony³

et al. 2019

CCR

View full text Add to dashboard Cite

Background: To detect the potential in hospital prognostic value of fQRS complex in patients with acute coronary syndrome (ACS) & investigate whether FQRS complex can be used to distinguish patients with early NSTEMI from those with unstable angina. Methods: It included 150 patients with acute NSTEMI and unstable angina. All patients were subjected to Grace score calculation, ECG to detect ischemic changes and detect presence or absent of fQRS, transthoracic echo to detect LV ejection fraction and recording in-hospital outcome. Results: Patients with fQRS have significant higher Killip class>2, higher troponin &CKMB levels, higher grace score, increased LVEDD & LVESD and significantly lower LVEF%. LVEF is significantly lower among patients with fQRS than patients with not fQRS in NSTEMI patients while there is no significant difference of LVEF % between both groups in unstable angina patients. There is significant association between fQRS and higher prevalence of NSTEMI and higher incidence of heart failure, arrhythmia and bad outcome. By multivariate analysis, NSTEMI (p =0.003) and high HR (p =0.004) and fragmented QRS (p =0.00) were the only significant predictors for bad outcome. FQRS have the ability to diagnose NSTEMI in 47.9% of cases, fQRs can truly exclude NSTEMI in 72.7% of case. Conclusion: Among patients with ACS, the presence of fQRS was associated with an increase incidence of complication, worse outcome, larger LV dimensions, and lower LVEF. The presence of fQRS in acute coronary syndrome patients could predict the presence of NSTEMI with fair diagnostic value.

show abstract

“…However, previous studies [ 29 – 31 ] reported that the occurrence of myocardial coronary perfusion abnormality in fQRS patients is significantly enhanced, and the predictive value for the cardiac death is significantly higher compared to non-fQRS patients. A previous study [ 32 ] reported that the fQRS complex acts as a prognostic marker for microvascular reperfusion and LV dysfunction. However, the present study investigated the function of fQRS in the adverse cardiac events in STEMI patients for the first time.…”

Section: Discussionmentioning

confidence: 99%

Fragmented QRS (fQRS) Complex Predicts Adverse Cardiac Events of ST-Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention and Thrombolysis

2018

Med Sci Monit

View full text Add to dashboard Cite

BackgroundST-segment elevation myocardial infarction (STEMI) is an acute and life-threatening disease. Adverse cardiac events (ACEs) are defined as cardiovascular death or worsening congestive heart failure in STEMI patients. The present study investigated the predictive role of fragmented QRS complex (fQRS) in risks of ACEs in STEMI.Material/MethodsThis study was a retrospective analysis involving patients who underwent percutaneous coronary intervention (PCI) or thrombolysis. STEMI patients were divided into the fQRS group (259 cases) and the non-fQRS group (161 cases). Basic information and clinical parameters were evaluated. ACEs, including hemodynamic instability, electrical instability (ventricular tachycardia event, ventricular fibrillation or atrioventricular heart-block) and death, were observed. The 12-lead ECG was used to obtain fQRS recordings. Thrombolytic recanalization was evaluated to confirm clinical outcomes of PCI and thrombolysis therapy.ResultsHemodynamic instability rates, electrical instability rates, and death in the fQRS group were significantly higher compared to the non-fQRS group (P=0.002, 0.000, and 0.010, respectively). PCI triggered significantly fewer ACEs compared to thrombolytic therapy in the fQRS group (P=0.000, 0.000, and 0.019, respectively). The fQRS group had higher thrombolysis failure rates and three-vessel lesion of coronary artery rates compared to the non-fQRS group (P=0.009 and 0.029, respectively). There were no differences between fQRS and non-fQRS groups in death rates of STEMI patients undergoing PCI and thrombolytic therapy. GRACE scores more than 140, EF less than 35%, and fQRS illustrated predictive potential for ACEs of STEMI patients.ConclusionsfQRS is an independent predictor for the adverse cardiac events of STEMI patients undergoing PCI or thrombolysis.

show abstract

Fragmented QRS complex is a prognostic marker of microvascular reperfusion and changes in LV function occur in patients with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention

Cited by 16 publications

References 42 publications

Prognostic significance of fragmented QRS in patients with ST-elevation myocardial infarction undergoing revascularization

Prognostic significance of fragmented QRS in patients with ST-elevation myocardial infarction undergoing revascularization

Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome

Fragmented QRS (fQRS) Complex Predicts Adverse Cardiac Events of ST-Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention and Thrombolysis

Contact Info

Product

Resources

About