Significance of fragmented QRS complexes for identifying culprit lesions in patients with non-ST-elevation myocardial infarction: a single-center, retrospective analysis of 183 cases

BMC Cardiovascular Disorders

Research Article

Yawei Xu¹  Yuanmin Li¹  Rong Guo¹  Kai Tang¹  Weimin Li¹ 

[1] Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 200072, Shanghai, China;

关键词: Fragmented QRS complexes;    Coronary artery disease;    Acute coronary syndrome;    Electrocardiogram;   

DOI  :  10.1186/1471-2261-12-44

 received in 2011-10-11, accepted in 2012-06-19,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundFragmented QRS (fQRS) complexes are novel electrocardiographic signals, which reflect myocardial conduction delays in patients with coronary artery disease (CAD). The importance of fQRS complexes in identifying culprit vessels was evaluated in this retrospective study.MethodsA 12-lead surface electrocardiogram was obtained in 183 patients who had non-ST-elevation myocardial infarction (NSTEMI) and subsequently underwent coronary angiography (CAG). On the basis of the frequency of fQRS complexes, indices such as sensitivity, specificity, positive and negative predictive values, and likelihood ratio were evaluated to determine the ability of fQRS complexes to identify the culprit vessels.ResultsAmong the patients studied, elderly patients (age ≥ 65 years) and those with diabetes had a significantly higher frequency of fQRS complexes (p = 0.005, p = 0.003, respectively). The fQRS complexes recorded in the 4 precordial leads had the highest specificity (81.8%) for indentifying the culprit vessel (left anterior descending artery). However, the specificity of fQRS complexes to identify lesions in the left circumflex and right coronary arteries was lower for the inferior and lateral leads than for the limb leads (65.5% versus 71.7%); however, the limb leads had higher sensitivity (92.3% versus 89.4%). And the total sensitivity and specificity of fQRS (77.1% and 71.5%) were higher than those values for ischemic T-waves.ConclusionsThe frequency of fQRS complexes was higher in elderly and diabetic patients with NSTEMI. The frequency of fQRS complexes recorded in each of the ECG leads can be used to identify culprit vessels in patients with NSTEMI.

【 授权许可】

Unknown   
© Guo et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.