Relationship between low QRS voltage ECG and hospital mortality of patients with acute inferior ST Segment Elevation Myocardial Infarction treated Primary Angioplasty

Abstract

Low QRS voltage on electrocardiogram is associated with left ventricular dysfunction and may increase short-term and long-term mortality in patients with acute myocardial infarction (MI). Also, it has been reported that the amplitude of the R-wave on the electrocardiogram indicates the amount of healthy and undamaged myocardium. The lower extremity is undergoing primary angioplasty. Materials & Methods: This cross-sectional study of all patients referred to Shahid Madani Center in 2017-2018 with the diagnosis of Inf. STEMI who underwent PPC1 were included in the study and divided into two groups based on the low or no voltage of the ECG and while comparing vital signs, laboratory tests, risk factors, echocardiographic and angiographic variables and electrocardiography in the two groups, the effect Low QRS voltage was assessed on number of hospital days, hospital mortality and long-term. Results: Of the 450 patients studied, 68.44% had low voltage and 31.55% had low ECG. There was no significant difference between the two groups in terms of mean age (P = 0.22) and gender composition (P = 0.89). Among the risk factors, smoking and shortness of breath were significantly higher in the group of patients with low voltage than the other group (p <0.001). Killip class> 1 was significantly higher in the group of patients with low voltage than in the group of patients without low voltage (P <0.001). The variable ST elevation in Lead aVR in the group of low voltage patients was significantly higher than the group of patients without low voltage (P = 0.002). Also, the frequency of people whose ST Resolution was higher than 50% in the group of patients without low voltage (77.3%) was significantly higher than the group of patients with low voltage (69%) (p = 0.02). Other risk factors, vital signs, laboratory tests, echocardiographic findings, angiography and electrocardiography were not significantly different between the two groups. The mean duration of Door to balloon (P = 0.42) and length of hospital stay (P = 0.96) were not significantly different between the two groups, while hospital mortality in the low-voltage group with 4.9% mortality compared to the group of patients without voltage. Low with 1.3% mortality was significantly higher (p = 0.04). Mortality one year later was 12.7% higher in patients with low voltage than in patients without low voltage (1.3%) (P <0.001). In general, logistic regression results showed low voltage on ECG (P <0.001), age (P = 0.001), female gender (P = 0.01), history of hypertension (P = 0.002) and low voltage (P <0.001). ) Independently affect one-year mortality.