dr Masrul
Faculty of Medicine, University of Indonesia/ Harapan Kita National Cardiovascular Center

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Predictive Value of Terminal QRS Distortion in Anterior Wall Acute Myocardial Infarction Masrul, dr; Setianto, Budhi; Haryono, Nur
Jurnal Kardiologi Indonesia Vol.28 No.3 Mei 2007
Publisher : Indonesian Heart Association

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Abstract

Background. The initial ECG at patients with Acute Coronary Syndrome, especially STEMI can predict size of infarction, response to reperfusion therapy and long term prognosis. A new classification, the QRS distortionhave increased mortality rates and larger infarct size and less limitation of their infarct size by thrombolytic therapy. QRS distortion is the emergence of J point = 50% of R wave in leads with qR configuration (I, aVL, V4-V6), or disappearance of the S wave in leads with Rs configuration (V1-V3).Methods and results. This study is cohort-retrospective to patients with anterior IMA treated by thrombolytic at National Cardiovascular Centre – Harapan Kita, Jakarta, Indonesia, during January 2003 – September 2004,that fulfill inclusion and exclusion criterias. They were divided into two group, with QRS distortion (+) and without QRS distortion (-); each group consist of 30 patients. Correlation between the two groups were analyzed by t test, chi-square test, Mann Whitney u test and logistic regression.Patients age range is 40 – 69 years, and mostly man. There is no difference between baseline characteristic in the two groups, except cholesterol LDL which is higher in the group with QRS distortion. Patients with QRS distortion have a higher tendency of thrombolytic therapy failure compare to patients without QRS distortion, (p=0,003). As the consequence they also have a higher rate of arrhythmia events, low ejectionfraction and re-hospitalization due to congestive heart failure.Conclusions. The prognosis of patients with anterior IMA associated with QRS distortion is worse than without QRS distortion.