| Objective: To investigate the relationship between the T-wave morphology of a VL and a VR leads in acute ST segment elevation myocardial infarction and the outcome and prognosis during hospitalization.For those admitted to the First Hospital of Jilin University cardiovascular units from January 1,2017 to June 30,2017 with a diagnosis of ST-segment elevation myocardial infarction(STEMI),a total of 559 individuals met the criteria for inclusion.Data was collected restrospectively and followed up for42?months(follow-up cutoff date: December 31,2020)as part of the methodology.Analysis of clinical data from 589 patients was conducted,comprising general data,disease information,coronary angiography information,and follow-up information.At admission,the T-wave direction of the electrocardiogram divided patients into two groups: those with T-wave upright(T ≥ 0mv)and those with T-wave non-upright(T＜0mv).To compare the two groups,SPSS26.0 was employed to analyze coronary artery disease,infarction related coronary artery,coronary artery disease branch number,clinical prognosis,and other indicators.Statistical analysis was conducted using a twosided test,with P ＜0.05 being deemed statistically significant.Results:(1)In the inverted T-wave group of a VL lead,age,hypertension history,low density lipoprotein,and BNP were all greater than in the upright Twave group.The analysis and comparison between the subgroups of the inverted T-wave group of av L lead: the higher the absolute value of T-wave amplitude,the higher the Killip grade,the higher the CTnl and DD in admission,the longer the coronary recanalization time,and the more serious the coronary lesions.(2)Patients in the a VR lead T wave upright group,with a higher proportion and length of hospital stay,were found to have a higher sex,age,diabetes,history of myocardial infarction,cardiac bypass graft,hypertension,BNP,LVEDD,Killip grade,LM and multi vessel disease,yet hemoglobin and left ventricular ejection fraction were lower.A comparison of subgroups of upright T wave in AVR lead revealed that,after 12 and 42 months,the T-wave upright group had a significantly higher rate of fatalities than the T-wave group.The absolute amplitude of the T wave was found to be linked to a greater AST,a longer coronary recanalization time,and a poorer diastolic function of the heart.3.After multivariate analysis,LVEF(P =0.054)was an independent risk factor for events during hospitalization.BNP was a risk factor for 12 month survival(P =0.014);Age(P =0.015)and LVEF(P =0.009)are risk factors for 42 month survival.4.A comparison between the a VR lead T wave upright and inverted groups revealed that the former had a greater heart rate,LVEDD,BNP,Killip grade,and D-D,lower left ventricular ejection fraction,and a significantly higher rate of fatalities at 12 and 42 months than the latter.However,the inverted group had more hospitalization events than the former.Conclusions :(1)Emergency PCI patients with acute ST-segment elevation myocardial infarction who had an upright T-wave in a VR lead on the admission electrocardiogram had a lower left ventricular ejection fraction,a longer hospital stay than non-fatal patients,a higher T-wave amplitude,a longer coronary recanalization time,and poorer cardiac diastolic function.(2)Emergency PCI in those suffering from acute ST-segment elevation myocardial infarction is accompanied by an elevated incidence of left main coronary artery and multiple branch lesions,as well as a poorer prognosis,in those with an upright T-wave in a VR lead on admission electrocardiogram.(3)The admission electrocardiogram reveals that the severity of coronary artery disease in patients with acute ST segment elevation myocardial infarction undergoing emergency PCI increases as the amplitude of the T wave increases,particularly in those with a VL lead T wave inversion.(4)The electrocardiogram of an a VR lead’s upright T-wave has a clinical significance in forecasting and assessing the result and prognosis of those with acute ST-segment elevation myocardial infarction who have undergone emergency PCI during hospitalization.(5)In ASTEMI patients,when the a VR and a VL leads are consistently upright on the T wave,cardiac function is significantly impaired,and short-term and long-term prognosis is worse. |
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