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Terminal QRS Complex Distortion on the Admission Electrocardiogram in Anterior Acute Myocardial Infarction and Association with Residual Flow and Infarct Size after Primary Angioplasty

Yang, Hyun Suk    (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.   ); Lee, Cheol Whan    (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.   ); Hong, Myeong-Ki    (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.   ); Moon, Dae-Hyuk    (Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.   ); Kim, Young-Hak    (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.   ); Lee, Sang-Gon    (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.   ); Han, Ki-Hoon    (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.   ); Kim, Jae-Joong    (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.   ); Park, Seong-Wook    (Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.   ); Park, Seung-Jung    (De  );
  • 초록

    Background Terminal QRS complex distortion on admission is a simple and reliable predictor of infarct size in patients with acute myocardial infarction (AMI). It is uncertain, however, whether this reflects reduced myocardial perfusion of the infarct area and a larger area of the myocardium at risk. This study was conducted to investigate whether terminal QRS distortion complex on admission is a reliable predictor of reduced residual flow and a larger area of the myocardium at risk compared to patients who are admitted without a terminal QRS distortion. Methods We evaluated the relationship between terminal QRS complex distortion and residual flow to the infarct zone and risk area in 46 anterior AMI patients undergoing primary angioplasty. 99m Tc-sestamibi imaging was performed at baseline and 5-9 days after angioplasty. The study population was divided into those with (Group I, n=16) and without (Group II, n=30) terminal QRS complex distortion. Results Baseline characteristics were similar between the two groups. The area of the myocardium at risk was higher in Group I (59.9±15.3%) than in Group II (48.6±13.7%, p p p Conclusion Terminal QRS complex distortion seems to be associated with less residual flow to the infarct zone, a larger risk area and greater infarct size in patients with anterior AMI.


  • 주제어

    Myocardial infarction .   QRS distortion .   Angioplasty.  

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