Fragmente QRS kompleksleri koroner anjiyografi uygulanan stabil koroner arter hastalarında daha yüksek Gensini skorunu öngördürmektedir
Öz
Amaç: Stabil koroner arter hastalığında (KAH) elektrokardiyografide (EKG) fragmente QRS (fQRS) varlığı ile anjiyografik olarak KAH yaygınlığı arasındaki ilişkiyi gösteren yeterli veri yoktur. Çalışmamızın amacı, stabil KAH nedeniyle elektif koroner anjiyografi uygulanan hastalarda Gensini skoru ile belirlenen KAH yaygınlığı ve toplam aterosklerotik yük ile EKG’de fQRS varlığı arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntem: Stabil KAH nedeniyle anjiyografi uygulanan 132 hasta çalışmaya dahil edildi. Hastalar EKG’de fQRS varlığı yada yokluğuna göre iki gruba ayrıldı. Her iki grup anjiyografik verilerden hesaplanan Gensini skoru açısından karşılaştırıldı.
Bulgular: 38 hastanın EKG’sinde fQRS varken 94 hastanın EKG’sinde fQRS mevcut değildi. Her iki grup demografik özellikler ve risk faktörleri açısından oldukça benzerdi. EKG’de fQRS olan hastalar olmayanlara göre istatistiksel olarak anlamlı düzeyde daha yüksek Gensini skoruna sahip olarak saptandı (39.8±24.6 vs. 21.2±15.3, p< 0.001).
Sonuç: EKG’de fQRS varlığı Gensini skoru ile belirlenen KAH yaygınlığının ve toplam aterosklerotik yükün önemli bir belirtecidir. Basit ve kolay saptanabilir bir bulgu olan fQRS, elektif anjiyografi uygulanacak stabil KAH hastalarında KAH yaygınlığını öngörmede kullanılabilir.
Anahtar Kelimeler
Kaynakça
- Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC guidelines on the management of stable coronary artery disease: The Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 2013;34(38):2949-3003.
- Das MK, Saha C, El Masry H, et al. Fragmented QRS on a 12-lead ECG: A predictor of mortality and cardiac events in patients with coronary artery disease. Heart Rhythm 2007;4(11):1385-92.
- Pietrasik G, Zareba W. QRS fragmentation: Diagnostic and prognostic significance. Cardiol J 2012;19(2):114-21.
- Eyuboglu M, Ekinci MA, Karakoyun S, Kucuk U, Senarslan O, Akdeniz B. Fragmented QRS for risk stratification in patients undergoing first diagnostic coronary angiography. Arq Bras Cardiol 2016;107(4):299-304.
- Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 1983;51(3):606.
- Neeland IJ, Patel RS, Eshtehardi P, et al. Coronary angiographic scoring systems: An evaluation of their equivalence and validity. Am Heart J 2012;164(4):547-52.e1
- Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013;34(28):2159-219.
- Das MK, Khan B, Jacob S, Kumar A, Mahenthiran J. Significance of a fragmented QRS complex versus a Q wave in patients with coronary artery disease. Circulation 2006; 113(21):2495-501.
- Patel MR, Peterson ED, Dai D, et al. Low diagnostic yield of elective coronary angiography. N Engl J Med 2010;362(10):886-95.
- Costa Filho FF, Chaves ÁJ, Ligabó LT, et al. Efficacy of patient selection for diagnostic coronary angiography in suspected coronary artery disease. Arq Bras Cardiol 2015;105(5):466-71.
- Bekler A, Barutçu A, Tenekecioglu E, et al. The relationship between fragmented QRS complexes and SYNTAX and Gensini scores in patients with acute coronary syndrome. Kardiol Pol 2015;73(4):246-54.
Fragmented QRS complexes predict higher Gensini score in stable coronary artery disease patients undergoing coronary angiography
Öz
Aim: There are no enough data regarding the association of fragmented QRS (fQRS) on electrocardiography (ECG) with angiographically detected coronary artery disease (CAD) severity in patients with stable CAD. We aimed to investigate the relationship of fQRS with CAD severity and total atherosclerotic burden that is defined by Gensini score in stable CAD patients undergoing elective coronary angiography.
Materials and Methods: 132 stable CAD patients who underwent elective coronary angiography were included into the study. Patients were divided into two groups regarding presence or absence of fQRS on ECG. The groups were compared regarding angiographically detected Gensini score.
Results: 38 patients had fQRS on ECG and 94 patients did not have fQRS on ECG. The groups were similar regarding demographic characteristics. Patients with fQRS on ECG had statistically significantly higher Gensini score compared to patients without fQRS. (39.8±24.6 vs. 21.2±15.3, p< 0.001).
Conclusion: Presence of fQRS on ECG is a predictor of CAD severity and total atherosclerotic burden detected by Gensini score. As a simple and easily accessible parameter, fQRS may be useful to predict CAD severity in stable CAD patients undergoing elective coronary angiography.
Anahtar Kelimeler
Kaynakça
- Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC guidelines on the management of stable coronary artery disease: The Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 2013;34(38):2949-3003.
- Das MK, Saha C, El Masry H, et al. Fragmented QRS on a 12-lead ECG: A predictor of mortality and cardiac events in patients with coronary artery disease. Heart Rhythm 2007;4(11):1385-92.
- Pietrasik G, Zareba W. QRS fragmentation: Diagnostic and prognostic significance. Cardiol J 2012;19(2):114-21.
- Eyuboglu M, Ekinci MA, Karakoyun S, Kucuk U, Senarslan O, Akdeniz B. Fragmented QRS for risk stratification in patients undergoing first diagnostic coronary angiography. Arq Bras Cardiol 2016;107(4):299-304.
- Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 1983;51(3):606.
- Neeland IJ, Patel RS, Eshtehardi P, et al. Coronary angiographic scoring systems: An evaluation of their equivalence and validity. Am Heart J 2012;164(4):547-52.e1
- Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013;34(28):2159-219.
- Das MK, Khan B, Jacob S, Kumar A, Mahenthiran J. Significance of a fragmented QRS complex versus a Q wave in patients with coronary artery disease. Circulation 2006; 113(21):2495-501.
- Patel MR, Peterson ED, Dai D, et al. Low diagnostic yield of elective coronary angiography. N Engl J Med 2010;362(10):886-95.
- Costa Filho FF, Chaves ÁJ, Ligabó LT, et al. Efficacy of patient selection for diagnostic coronary angiography in suspected coronary artery disease. Arq Bras Cardiol 2015;105(5):466-71.
- Bekler A, Barutçu A, Tenekecioglu E, et al. The relationship between fragmented QRS complexes and SYNTAX and Gensini scores in patients with acute coronary syndrome. Kardiol Pol 2015;73(4):246-54.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2018 |
| Gönderilme Tarihi | 24 Nisan 2017 |
| Yayımlandığı Sayı | Yıl 2018Cilt: 57 Sayı: 2 |
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