The Relationship Between Severity Of Coronary Artery Disease And Left Ventricular Function Assessed By Selvester QRS Score In Patients With Acute Myocardial Infarction

Objective:The Selvester QRS score(SQs)in patients with Acute myocardial infarction(AMI)was calculated by 12-guide electrocardiogram to investigate the relationship between SQs and the severity of coronary artery lesions and left ventricular function in AMI patients.Method:A total of 468 patients who underwent percutaneous coronary intervention(PCI)for AMI first diagnosed due to chest distress and chest pain in the Department of Cardiology of the Second Affiliated Hospital of Kunming Medical University from January 2018 to April 2020 were selected,and SQs was calculated and divided into SQs<3(179cases),SQs≥3(289cases)according to the median.Collect relevant clinical data of the included subjects,compares two groups of coronary artery lesions,Gensini score and Left ventricular structure and function.Spearman correlation analysis was used to determine the relationship between Left ventricular ejection fraction(LVEF)and SQs,and binary logistic regression analysis was used to explore the influencing factors of SQs≥3.Results:1.There was no significant difference in demographic data,previous history,medication history,criminal blood vessels,biochemical indicators between the two groups of AMI patients(P>0.05).There were statistically significant differences between the two groups in the type of myocardial infarction(STEMI)and the presence of fQRS(P<0.05).2.The number of vascular lesions and the degree of coronary artery lesions were compared.There was no significant difference between the two groups in single-vessel and double-vessel lesions(P>0.05),but more than three vessels in SQs≥3 group was higher than SQs<3 groups,the difference was statistically significant(P=0.002).3.Comparing the structure and function of the left heart,there was no statistical significance between the two groups in LADd,LVPWT,E peak,A peak(P>0.05),there was statistically significant difference between IVDd,IVST,LVEF,NT-proBNP groups(P=0.02、0.007、0.018、0.000).There was no statistically significant difference between the two groups when Killip class was Grade Ⅰ-Ⅱ(P>0.05),and the difference was statistically significant in Killip class Ⅲ-Ⅳ(P<0.05).4.Correlation analysis of the correlation between LVEF and SQs showed that the correlation coefficient was-0.156,P=0.001,suggesting a statistically significant and negative correlation between the two.Linear regression was performed to infer the equation:LVEF(%)=58.84-(0.49 x SQs).Bariate logistic regression analysis showed that SQs≥3 score was associated with the ST-segment elevation myocardial infarction(STEMI)and fragmented QRS(fQRS)(P<0.05).Conclusion:1.SQs can reflect the degree of coronary artery disease and left ventricular function in patients with AMI to some extent,indicating that the larger the area of myocardial infarction,the more severe the coronary artery disease,and the worse the left ventricular function.2.SQs is negatively correlated with LVEF,which can be used to preliminarily evaluate LVEF in patients with AMI,and has certain clinical reference significance3.When AMI type is STEMI and fQRS is present,SQs may be larger,which should be paid more attention in clinical practice.