The relationship between terminal QRS complex distortion and early low dose dobutamine stress echocardiography in acute anterior myocardial infarction

dc.contributor.authorSucu, MM
dc.contributor.authorKaradede, A
dc.contributor.authorAydinalp, O
dc.contributor.authorOzturk, O
dc.contributor.authorToprak, N
dc.date.accessioned2024-04-24T17:18:04Z
dc.date.available2024-04-24T17:18:04Z
dc.date.issued2004
dc.departmentDicle Üniversitesien_US
dc.description.abstractAlthough the damage in myocardial infarction has been demonstrated to be related with the magnitude and number of ST elevation, its relation with terminal distortion of QRS is unclear. The relationship between terminal QRS distortion in ECGs on admission and the results of early low dose dobutainine stress echocardiography (LDSE) performed 6 +/- 2 days later was investigated. Patients admitted to our clinic within the first six hours of their chest pain and without a prior infarction diagnosis were divided into two groups based on the admission electrocardiogram as the absence (QRS-, n = 33) or presence (QRS+, n = 29) of distortion of the terminal portion of the QRS in greater than or equal to 2 leads (QRS+; J point at > 50% of the R wave amplitude in lateral leads or presence of ST elevation without S wave in leads V-1-V-3). There were no significant differences between the groups with respect to thrombolytic therapy or reperfusion criteria, During LDSE, the infarct zone wall motion score index (WMSI) in the QRS- group was significantly decreased relative to baseline (from 2.93 +/- 0.65 to 2.37 +/- 0.84, P = 0.02), and it was significantly different compared with WMSI in the QRS+ group (P = 0.005). Improvement of akinetic regions to hypokinetic regions in the infarct zone (IZ) was found to be 33:5% (44/131) in the QRS- group and 17.8% (27/ 151 P = 0.004) in the QRS+ group. Furthermore, 55.1% (10/29) of the patients in the QRS+ group and only 18.1% (6/33) of those in the QRS- group did not respond to LDSE (P > 0.05). In multiple logistic regression analysis, while. there was no relationship between good left ventricular functions (WMSI < 2) and terminal QRS distortion under basal conditions (P = 0.07), an independent relation was observed to exist between them after LDSE (P = 0.03, OR 4.48, 95% CI, 1.13-17.7). Moreover, plasma CK levels were higher in the QRS+ group (P = 0.03), whereas the ejection fraction was worse (P = 0.01). In both groups, there was no correlation between the Selvester score and left ventricle WMSI at baseline, but this correlation was significantly improved with LDSE (QRS-; r = 0.39 P 0.02 and QRS+; r = 0.44 P = 0.01). The viability in the IZ is relatively less in those patients with terminal QRS distortion observed in their ECG on admission. This simple classification would be useful in predicting left ventricular function at the time of discharge.en_US
dc.identifier.doi10.1536/jhj.45.373
dc.identifier.endpage386en_US
dc.identifier.issn0021-4868
dc.identifier.issue3en_US
dc.identifier.pmid15240958
dc.identifier.scopus2-s2.0-3442893585
dc.identifier.scopusqualityN/A
dc.identifier.startpage373en_US
dc.identifier.urihttps://doi.org/10.1536/jhj.45.373
dc.identifier.urihttps://hdl.handle.net/11468/18581
dc.identifier.volume45en_US
dc.identifier.wosWOS:000223527600002
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherJapan Heart Journal, Second Dept Of Internal Meden_US
dc.relation.ispartofJapanese Heart Journal
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectEchocardiographyen_US
dc.subjectElectrocardiographyen_US
dc.subjectMyocardial Infarctionen_US
dc.subjectNecrosisen_US
dc.titleThe relationship between terminal QRS complex distortion and early low dose dobutamine stress echocardiography in acute anterior myocardial infarctionen_US
dc.titleThe relationship between terminal QRS complex distortion and early low dose dobutamine stress echocardiography in acute anterior myocardial infarction
dc.typeArticleen_US

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