Lin Li , Zhe Li , Li Li , Ying Wang , Haizhou Zhang
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Each patient was observed and followed for 12 months.</p></div><div><h3>Results</h3><p>Cox multivariate logistic regression analysis indicated that the dynamic deeper fQRS complex was an independent predictor of long-term mortality (HR: 5.563, 95 % CI: 1.079–28.678, <em>P</em> = 0.040) in patients with APE. Kaplan–Meier curve analysis revealed that the event-free survival of the fQRS shallower group significantly increased relative to that of the fQRS deeper group and that of the fQRS deeper group significantly decreased relative to that of the fQRS unchanged group and shallower group (P = 0.022, P = 0.041).</p></div><div><h3>Conclusion</h3><p>Compared with the deeper fQRS complex, the dynamic shallower fQRS complex was an indicator of a good prognosis in APE patients, while the dynamic deeper fQRS complex indicated a poor prognosis. Dynamical changes in fQRS may assist clinicians in risk stratification and individualized treatment for APE, as well as in predicting APE regression or progression.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 1-8"},"PeriodicalIF":2.4000,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Significance of dynamic changes in the fragmented QRS complex in acute pulmonary embolism\",\"authors\":\"Lin Li , Zhe Li , Li Li , Ying Wang , Haizhou Zhang\",\"doi\":\"10.1016/j.hrtlng.2024.05.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Dynamic changes in the fQRS complex between the initial and follow-up ECG in patients with acute pulmonary embolism (APE) have rarely been studied.</p></div><div><h3>Objective</h3><p>The purpose of this study was to investigate the significance of dynamic changes in the fragmented QRS complex in APE patients.</p></div><div><h3>Methods</h3><p>APE patients (n = 222) were divided into three groups based on their ECG data to determine whether there were dynamic changes in the fQRS complex from admission to follow-up at one month: the fQRS shallower group (n = 49), fQRS deeper group (n = 25) and fQRS unchanged group (n = 148). Each patient was observed and followed for 12 months.</p></div><div><h3>Results</h3><p>Cox multivariate logistic regression analysis indicated that the dynamic deeper fQRS complex was an independent predictor of long-term mortality (HR: 5.563, 95 % CI: 1.079–28.678, <em>P</em> = 0.040) in patients with APE. Kaplan–Meier curve analysis revealed that the event-free survival of the fQRS shallower group significantly increased relative to that of the fQRS deeper group and that of the fQRS deeper group significantly decreased relative to that of the fQRS unchanged group and shallower group (P = 0.022, P = 0.041).</p></div><div><h3>Conclusion</h3><p>Compared with the deeper fQRS complex, the dynamic shallower fQRS complex was an indicator of a good prognosis in APE patients, while the dynamic deeper fQRS complex indicated a poor prognosis. Dynamical changes in fQRS may assist clinicians in risk stratification and individualized treatment for APE, as well as in predicting APE regression or progression.</p></div>\",\"PeriodicalId\":55064,\"journal\":{\"name\":\"Heart & Lung\",\"volume\":\"68 \",\"pages\":\"Pages 1-8\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-06-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart & Lung\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0147956324000980\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart & Lung","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0147956324000980","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：急性肺栓塞（APE）患者初始心电图和随访心电图之间fQRS复合体的动态变化很少被研究：本研究旨在探讨 APE 患者 QRS 波群片段动态变化的意义：根据心电图数据将APE患者（n = 222）分为三组，以确定从入院到随访一个月期间fQRS复合体是否发生动态变化：fQRS较浅组（n = 49）、fQRS较深组（n = 25）和fQRS不变组（n = 148）。每名患者均接受了 12 个月的观察和随访：Cox多变量逻辑回归分析表明，动态较深的fQRS复合体是APE患者长期死亡率的独立预测因子（HR：5.563，95 % CI：1.079-28.678，P = 0.040）。Kaplan-Meier曲线分析显示，fQRS较浅组的无事件生存率相对于fQRS较深组明显增加，而fQRS较深组的无事件生存率相对于fQRS不变组和较浅组明显降低（P = 0.022，P = 0.041）：结论：与较深的fQRS复合体相比，动态较浅的fQRS复合体是APE患者预后良好的指标，而动态较深的fQRS复合体则预示着预后不良。fQRS 的动态变化可能有助于临床医生对 APE 进行风险分层和个体化治疗，也有助于预测 APE 的消退或进展。
Significance of dynamic changes in the fragmented QRS complex in acute pulmonary embolism
Background
Dynamic changes in the fQRS complex between the initial and follow-up ECG in patients with acute pulmonary embolism (APE) have rarely been studied.
Objective
The purpose of this study was to investigate the significance of dynamic changes in the fragmented QRS complex in APE patients.
Methods
APE patients (n = 222) were divided into three groups based on their ECG data to determine whether there were dynamic changes in the fQRS complex from admission to follow-up at one month: the fQRS shallower group (n = 49), fQRS deeper group (n = 25) and fQRS unchanged group (n = 148). Each patient was observed and followed for 12 months.
Results
Cox multivariate logistic regression analysis indicated that the dynamic deeper fQRS complex was an independent predictor of long-term mortality (HR: 5.563, 95 % CI: 1.079–28.678, P = 0.040) in patients with APE. Kaplan–Meier curve analysis revealed that the event-free survival of the fQRS shallower group significantly increased relative to that of the fQRS deeper group and that of the fQRS deeper group significantly decreased relative to that of the fQRS unchanged group and shallower group (P = 0.022, P = 0.041).
Conclusion
Compared with the deeper fQRS complex, the dynamic shallower fQRS complex was an indicator of a good prognosis in APE patients, while the dynamic deeper fQRS complex indicated a poor prognosis. Dynamical changes in fQRS may assist clinicians in risk stratification and individualized treatment for APE, as well as in predicting APE regression or progression.
期刊介绍：
Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders.
The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.
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