The Relationship of Early Repolarization Morphology with Prognosis and Mortality Accompanied by Angiography Results
Öz
Objective: Early repolarization (ER) is a common finding in cases. It can be benign or malignant. We aimed to evaluate the effects of early repolarization morphology and electrocardiogram (ECG) findings on the clinic, prognosis, and mortality with angiography findings.
Method: This retrospective study included 442 patients who were admitted to the emergency department between January 2010 and December 2015 and had ER in their ECG. The patients were divided into two groups according to the horizontal and ascending ER morphology. According to the derivation, four groups were formed as inferior, inferolateral, anterior, and common. Besides, four groups were determined according to the angiography findings: left anterior descending (LAD), circumflex (Cx), right coronary artery (RCA), and normal.
Results: The average age of the patients in the study was 52.16±9.07 years and 260(58.8%) were male. Horizontal morphology was observed in 123(28%) of the patients and ascending morphology in 319(72%). Mortality was detected in 9(7.3%) of the horizontal group and 6(1.9%) of the ascending group (p=0.008). In the angiography results of the mortality group, 8(53.3%) patients had Cx, 4(26.7%) patients had RCA and 3(20%) patients had LAD occlusion. Angiography results of 318(74.5%) surviving patients were normal (p=0.001). Mortality; It had a strong positive correlation with family history, Brugada Syndrome, aVR ST-segment formation and the presence of syncope, and moderate positive correlation with gender, notch presence, QRS morphology in V1-2, and angiography results.
Conclusions: Early repolarization morphology may be a helpful finding for prognosis, mortality, and interventional angiography decisions.
Anahtar Kelimeler
Emergency Department Early Repolarization Mortality Angiography
Destekleyen Kurum
None
Teşekkür
None
Kaynakça
- Tikkanen JT, Junttila MJ, Anttonen O, Aro AL, Luttinen S, Kerola T, et al. Early repolarization: electrocardiographic phenotypes associated with favorable long-term outcome. Circulation 2011;123(23):2666-73.
- Pérez-Riera AR, Abreu LC, Yanowitz F, Barros RB, Femenía F, McIntyre WF, Baranchuk A. "Benign" early repolarization versus malignant early abnormalities: clinical-electrocardiographic distinction and genetic basis. Cardiol J, 2012;19(4):337-46.
- Gussak I, Antzelevitch C. Early repolarization syndrome: clinical characteristics and possible cellular and ionic mechanisms. J Electrocardiol, 2000;33(4):299-309.
- Klatsky AL, Oehm R, Cooper RA, Udaltsova N, Armstrong MA. The early repolarization normal variant electrocardiogram: correlates and consequences. Am J Med, 2003;115:171–7.
- Mizusawa Y, Bezzina CR. Early repolarization pattern: its ECG characteristics, arrhythmogeneity and heritability. J Interv Card Electrophysiol, 2014;39(3):185–92.
Erken Repolarizasyon Morfolojisinin Anjiyografi Sonuçları Eşliğinde Prognoz ve Mortalite ile İlişkisi
Öz
Amaç: Erken repolarizasyon (ER) sık görülen bir bulgudur. Benign ya da malign karakterde olabilir. Erken repolarizasyon morfolojisi ve elektrokardiyogram (EKG) bulgularının anjiyografi bulguları ile klinik, prognoz ve mortalite üzerine etkilerini değerlendirmeyi amaçladık.
Metod: Bu retrospektif çalışmaya Ocak 2010 ile Aralık 2015 arasında acil servise başvuran ve EKG'sinde ER olan 442 hasta dahil edildi. Hastalar ER morfolojisinin yatay ve dikey olmasına göre iki gruba ayrıldı. Derivasyona göre ise inferior, inferolateral, anterior ve yaygın olmak üzere dört grup oluşturuldu. Ayrıca anjiyografi bulgularına göre sol ön inen (LAD), sirkumfleks (Cx), sağ koroner arter (RCA) ve normal olmak üzere dört grup belirlendi.
Bulgular: Çalışmaya alınan hastaların yaş ortalaması 52.16±9.07 yıl ve 260'ı (%58.8) erkekti. Hastaların 123'ünde(%28) yatay, 319'unda(%72) dikey morfoloji izlendi. Yatayl grupta 9(%7.3) ve dikey grupta 6(%1.9) olguda mortalite saptandı (p=0.008). Mortalite grubunun anjiyografi sonuçlarında 8 (%53,3) hastada Cx, 4 (%26,7) hastada RCA ve 3 (%20) hastada LAD oklüzyonu vardı. Yaşayan 318 (%74,5) hastanın anjiyografi sonuçları normaldi (p=0,001). Mortalitenin; aile öyküsü, brugada sendromu, aVR ST-segment varlığı ve senkop ile güçlü, cinsiyet, notch varlığı, V1-2'de QRS morfolojisi ve anjiyografi sonuçları ile orta düzeyde pozitif korelasyonu tespit edildi.
Sonuç: Erken repolarizasyon morfolojisi, prognoz, mortalite ve girişimsel anjiyografi kararları için yardımcı bir bulgu olabilir.
Anahtar Kelimeler
Kaynakça
- Tikkanen JT, Junttila MJ, Anttonen O, Aro AL, Luttinen S, Kerola T, et al. Early repolarization: electrocardiographic phenotypes associated with favorable long-term outcome. Circulation 2011;123(23):2666-73.
- Pérez-Riera AR, Abreu LC, Yanowitz F, Barros RB, Femenía F, McIntyre WF, Baranchuk A. "Benign" early repolarization versus malignant early abnormalities: clinical-electrocardiographic distinction and genetic basis. Cardiol J, 2012;19(4):337-46.
- Gussak I, Antzelevitch C. Early repolarization syndrome: clinical characteristics and possible cellular and ionic mechanisms. J Electrocardiol, 2000;33(4):299-309.
- Klatsky AL, Oehm R, Cooper RA, Udaltsova N, Armstrong MA. The early repolarization normal variant electrocardiogram: correlates and consequences. Am J Med, 2003;115:171–7.
- Mizusawa Y, Bezzina CR. Early repolarization pattern: its ECG characteristics, arrhythmogeneity and heritability. J Interv Card Electrophysiol, 2014;39(3):185–92.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 29 Haziran 2022 |
| Kabul Tarihi | 27 Nisan 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 14 Sayı: 2 |
