Relationship between QRS score and microvascular obstruction after acute anterior myocardial infarction

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• 作者：Naoki Watanabe ; MD^a ; ^b ; Satoshi Isobe ; MD ; PhD^a ; ^{sisobe@med.nagoya-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Takahiro Okumura ; MD ; PhD^a ; Hiroaki Mori ; MD^a ; Takashi Yamada ; MD^b ; Kazuyuki Nishimura ; MD^a ; ^b ; Manabu Miura ; MD^b ; Shinichi Sakai ; MD^b ; Toyoaki Murohara ; MD ; PhD^a
• 关键词：QRS score ; Electrocardiogram ; Microvascular obstruction ; Cardiac magnetic resonance imaging ; Acute anterior myocardial infarction
• 刊名：Journal of Cardiology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：67
• 期：4
• 页码：321-326
• 全文大小：779 K

文摘

The QRS score on electrocardiogram (ECG) in patients with myocardial infarction (MI) reportedly reflects the severity of myocardial damage. The presence of microvascular obstruction (MO) assessed by cardiac magnetic resonance (CMR) imaging is associated with irreversible myocardial damage. MO assessed by CMR is known to be a predictor for adverse clinical outcome after ST-elevation MI. The aim of the present study was to examine the relationship between QRS score and MO in acute anterior MI patients.

absSec_2">Methods

ar0010">Sixty-two patients with first acute anterior MI who successfully underwent primary percutaneous coronary intervention (PCI) were enrolled. The QRS score after PCI on admission ECG was calculated by a Selvester–Wagner QRS scoring system. CMR imaging was performed at 11.4 ± 3.9 days after MI. MO was defined as delayed enhancement with contrast-devoid core. Patients were divided into two groups as follows: 37 patients who showed MO (MO group) and 25 patients who did not show it (non-MO group).

absSec_3">Results

ar0015">The QRS score was significantly greater in the MO group than in the non-MO group. The QRS score significantly correlated with MO volume (r = 0.418, p = 0.010). Multivariate analysis showed that the QRS score (odds ratio 1.362, 95% CI: 1.038&ndash;1.951, p = 0.024) and the peak creatine kinase levels (odds ratio 1.001, 95% CI: 1.000&ndash;1.002, p < 0.001) were independent predictors for MO.

absSec_4">Conclusions

ar0020">Our results indicate that the QRS score derived from simple and widely available ECG may be a useful parameter for assuring the presence of MO.