ABSTRACT
Objective:To explore the relationship between electrocardiogram QRS wave duration and pathological parameters of acute myocardial infarction and its prognosis.Methods:The patients with acute myocardial infarction treated in Hunan Brain Hospital from January 2018 to June 2019 were divided into normal group (≤110 ms, NG group) and extended group (>110 ms, EG group) according to the time limit of QRS wave group of electrocardiogram (ECG). The clinicopathological data of the two groups were collected, and the differences of relevant pathological parameters between the two groups were compared. The correlation between ECG QRS complex time limit and pathological parameters of acute myocardial infarction and the independent risk factors affecting the occurrence of malignant cardiovascular events after acute myocardial infarction were analyzed.Results:A total of 134 patients were enrolled, 73 in the EG group, and 61 in the NG group. The plasma levels of N-terminal pro-brain natriuretic peptide (N-proBNP) in EG group were significantly higher than those in NG group ( P<0.05), and left ventricular ejection fraction (LVEF) was significantly lower than that in NG group ( P<0.05). The time limit of QRS wave group in EG group was positively correlated with the plasma levels of N-proBNP ( r=0.981, P<0.001) and negatively correlated with LVEF ( r=-0.979, P<0.001). The ratio of Killip grade Ⅰ patients in EG group were lower than those in NG group ( P<0.05), while the ratio of grade Ⅱ and Ⅲ patients were significantly higher than those in NG group ( P<0.05), and there was no significant difference between the two groups in grade Ⅳ patients ( P>0.05). The incidence of malignant cardiovascular events (cardiogenic shock, malignant arrhythmia, acute pulmonary edema, cardiogenic death and re-infarction) in EG group was significantly higher than that in NG group ( P<0.05). Multivariate logistic regression analysis showed that elevated serum N-proBNP, decreased LVEF, prolonged QRS wave duration and high Killip cardiac function were independent risk factors for malignant cardiovascular events after acute myocardial infarction. Conclusions:After acute myocardial infarction, EG patients have worse cardiac function, higher incidence of malignant cardiovascular events and worse prognosis than NG patients.