title: The assessment of relationship between fragmented QRS complex and left ventricular wall motion score index in patients with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention.
abstract: OBJECTIVE
  Fragmented QRS (fQRS) has been found to be associated with high mortality and arrhythmic events in acute coronary syndromes. Regional systolic function using wall motion score index (WMSI) is an alternative to left ventricular ejection fraction (LVEF) for the assessment of left ventricular systolic function. The aim of this study was to investigate the relation between the presence of fQRS on admission electrocardiogram (ECG) and WMSI in ST elevation myocardial infarction (STEMI) underwent primary coronary intervention (PCI). The in-hospital and long-term prognostic significance of persistent fQRS was also evaluated.
  
  
  METHODS
  In this retrospective study, 542 patients with a diagnose of STEMI underwent primary PCI were included. Study patients were divided into two groups according to the presence (n = 153) or absence (n = 389) of a fQRS on admission ECG.
  
  
  RESULTS
  WMSI was found to be significantly higher in fQRS(+) group compared to the fQRS(-) group (P < 0.001). In multivariete analysis, WMSI was found to be an independent predictor of fQRS, and fQRS was inversely associated with LVEF. The in-hospital reinfarction (P = 0.003), MACE (P = 0.024), intraaortic balloon pump use (P = 0.014), and advanced heart failure (P < 0.001) were found to be significantly more frequent in the fQRS(+) group. The presence of fQRS on admission was found to be associated with an increase in long-term cardiovascular mortality (P = 0.028), and long-term all-cause mortality (P = 0.022).
  
  
  CONCLUSIONS
  WMSI was significantly related with the presence of the fQRS, which reflects the linking between impairment of regional left ventricular systolic function and the presence of severe myocardial injury in STEMI.
authors.affiliation: Cardiology Department, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Nevzat
authors.initials: N
authors.lastname: Uslu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gul
authors.forename: Huseyin Altug
authors.initials: HA
authors.lastname: Cakmak
authors.forename: Ali
authors.initials: A
authors.lastname: Atam
authors.forename: Hamdi
authors.initials: H
authors.lastname: Pusuroglu
authors.forename: Hulusi
authors.initials: H
authors.lastname: Satilmisoglu
authors.forename: Emre
authors.initials: E
authors.lastname: Akkaya
authors.forename: Hale Unal
authors.initials: HU
authors.lastname: Aksu
authors.forename: Ali Kemal
authors.initials: AK
authors.lastname: Kalkan
authors.forename: Ozgur
authors.initials: O
authors.lastname: Surgit
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erturk
authors.forename: Huseyin
authors.initials: H
authors.lastname: Aksu
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Eksik
mesh_terms: D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: fragmented QRS; left ventricular systolic function; mortality