Value Of Electrocardiogram FQRS In The Diagnosis Of Coronary Heart Disease

Objective: In this study,the presence and number of fragmented QRS complex(fQRS)in 12 leads of electrocardiogram in patients with common coronary heart disease were studied,and the correlation between the abnormal fQRS index and the type of coronary heart disease was explored.The correlation between the occurrence of fQRS wave and the number of fQRS leads and the severity of coronary artery lesions and the number of branches were further studied.Methods:In this retrospective study,patients with four common types of coronary heart disease who underwent coronary angiography in Yijishan Hospital,Wannan Medical College between April 1,2021 and March 31,2022 were collected.A total of 408 patients were collected according to the inclusion and exclusion criteria,including 55 cases of SAPA,131 cases of UA,71 cases of NSTEMi,and 151 cases of STEMi.At the same time,electrocardiogram and other clinical indicators of patients within 48 hours after admission were collected,general data were analyzed,and the patients were divided into 168 fQRS positive group and 240 fQRS negative group according to the presence or absence of broken QRS wave.To investigate whether fQRS has relevant clinical significance for the above four clinical types(SAP,UA,NSTEMI,STEMI),the diagnostic value of fQRS in the degree of stenosis of coronary lesions(which can be divided into moderate stenosis,severe stenosis,and complete occlusion group according to coronary angiography results),and the relationship between fQRS and the number of branches of coronary lesions(according to coronary artery)Whether the most severe stenosis degree was ≥50%,the patients were divided into single,double,triple vessel lesion group);At the same time,the relationship between the number of abnormal fQRS leads and the degree of coronary artery lesions and the number of coronary artery lesions was studied(according to the number of pathological ECG leads,they could be divided into two fQRS group and two or more fQRS group).The relationship between fQRS and coronary heart disease patients was studied by the above grouping,and the clinical data were combined to discuss.Results:After statistical analysis of the data of 408 patients,1.From the point of general conditions and biochemical indicators,there were differences in BMI,high uric acid,creatine kinase,creatine kinase isoenzyme,troponin,high-sensitivity troponin,white blood cell,low density lipoprotein and LVEF between patients with and without fQRS(P < 0.05).There was no significant difference in other general data.(2)Among the disease types,the four diseases in fQRS positive group were SAP15 cases(27.27%),UA42 cases(32.06%),NSTEMI32 cases(45.07%),and STEMI79 cases(52.32%).In fQRS negative group,the four diseases were SAP40 cases(72.73%),UAA 89 cases(67.94%),NSTEMI39 cases(54.93%),and STEMI72 cases(47.68%).The proportion of FQRS in STEMI patients was higher than that in UA patients and SAP patients,and the differences were statistically significant(P<0.0167).There was no significant difference in other disease types.(3)In the number of coronary artery lesions,the proportion of single,double and three vessel lesions in fQRS positive group and fQRS negative group were 40 cases(23.81%)and 114 cases(47.50%),45 cases(26.79%)and65 cases(27.08%),83 cases(49.40%)and 61 cases(25.42%),respectively.The proportion of fragmented QRS complex in patients with three-vessel disease was higher than that in patients with double-vessel disease and single-vessel disease,and the proportion of fragmented QRS complex in patients with double-vessel disease was higher than that in patients with single-vessel disease,and the differences were statistically significant(P<0.0167).(4)In the degree of coronary artery lesions,the proportions of moderate coronary stenosis,severe coronary stenosis and total occlusion in fQRS positive group and fQRS negative group were: 17 cases(10.12%)and 55 cases(22.92%),105 cases(62.50%)and 135 cases(56.25%),46 cases(27.38%)and 50 cases(20.83%).The proportion of FQRS in patients with total occlusion and severe lesions was significantly higher than that in patients with moderate lesions(P<0.0167).The proportion of FQRS in patients with total occlusion was higher than that in patients with severe lesions,but the difference was not statistically significant.(5)In the number of electrocardiographic leads,there were 57 cases(33.93%)with fQRS in two leads and111 cases(66.07%)with fQRS in more than two leads.The number of coronary artery lesions and the degree of coronary artery lesions in patients with fragmented QRS complex in more than 2 leads were more severe than those in patients with fragmented QRS complex in 2 leads,and the difference was statistically significant.There were significant differences between patients with three-vessel disease and double-vessel disease and single-vessel disease,and between patients with total occlusion and moderate disease(P<0.0167).Conclusion:(1)fQRS wave may have important diagnostic significance in STEMI patients.(2)fQRS wave has a certain predictive value for the degree of coronary artery stenosis and the number of coronary artery lesions.(3)The number of fQRS leads in ECG may indicate the severity of coronary artery lesions and the number of coronary artery lesions.