Background

QRS distortion (G3I) and frontal QRS-T angle (fQRS-T angle) are both electrocardiographic (ECG) signs of ongoing ischemia and depolarization–repolarization heterogeneity, which always occur in patients with ST-segment elevation acute myocardial infarction (STEMI).

Methods

We retrospectively collected 592 STEMI patients who underwent coronary angiography and follow-up for 42 months. 1. We divided the patients into two groups according to whether they had G3I on admission, compared the differences in examination data and endpoint events between these two groups. 2. Group patients according to whether the endpoint events happened in hospital, at 12 and 42 months, compare whether there is a difference in fQRS-T angle at the same time point, and find out the predictive cutoff value of all-cause death. 3. Combined G3I and fQRS-T angle together to enhance the predictive value.

Results

G3I and fQRS-T angle are both independent risk factors for all-cause death in STEMI patients within 12 months (G3I P = 0.014, fQRS-T angle P < 0.001) and within 42 months (P < 0.001). The cutoff values of fQRS-T angle for predicting all-cause death are 66.5° at 12 months and 90.5° at 42 months. When G3I and fQRS-T angle are combined used to predict the mortality, the specificity is significantly improved, but the sensitivity decreased.

Conclusions

G3I and fQRS-T angles are valuable in the prognostic assessment of STEMI patients, especially when combined. These findings help clinicians to identify high-risk patients early for more aggressive treatment.

中文翻译：

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ST段抬高型心肌梗死患者QRS波畸变和额叶QRS-T角的预后意义

背景

QRS 畸变 (G3I) 和额叶 QRS-T 角 (fQRS-T 角) 都是持续缺血和去极化-复极异质性的心电图 (ECG) 体征，通常发生在 ST 段抬高型急性心肌梗死 (STEMI) 患者中。

方法

我们回顾性收集了 592 名接受冠状动脉造影和随访 42 个月的 STEMI 患者。1.我们根据入院时是否有G3I将患者分为两组，比较两组检查数据和终点事件的差异。2.根据终点事件是否在医院发生分组，分别在12个月和42个月，比较同一时间点fQRS-T角是否存在差异，找出全因死亡的预测临界值。3. 将 G3I 和 fQRS-T 角结合起来，提高预测值。

结果

G3I 和 fQRS-T 角都是 STEMI 患者 12 个月内（​​G3I P  = 0.014，fQRS-T 角P  < 0.001）和 42 个月内（​​P < 0.001）全因死亡的独立危险因素。fQRS-T 角预测全因死亡的截止值为 12 个月时为 66.5°，42 个月时为 90.5°。G3I和fQRS-T角联合预测死亡率时，特异性显着提高，但敏感性下降。

结论

G3I 和 fQRS-T 角度在 STEMI 患者的预后评估中很有价值，尤其是在联合使用时。这些发现有助于临床医生及早识别高危患者以进行更积极的治疗。