Koroner arteriyel baskınlık ve QRS ekseni arasındaki ilişki

Abstract

Amaç: Koroner arter baskınlığı, sol veya sağ koroner dolaşım tarafından perfüze edilen miyokardın miktarını ve anatomik konumunu etkiler. Ancak, koroner arter baskınlığı ile 12-lead yüzey elektrokardiyografisindeki (EKG) QRS ekseni arasındaki ilişki araştırılmamıştır. Bu çalışma, ciddi koroner arter ve yapısal kardiyak hastalığı olmayan hastalarda koroner arter baskınlığı ile yüzey EKG’ deki QRS ekseni arasındaki ilişkiyi değerlendirmeyi amaçlamaktadır.

Gereç ve Yöntemler: Ciddi koroner arter hastalığı olmayan ve dahil etme kriterlerini karşılayan tam olarak 133 hasta bu çalışmaya katılmıştır. Tüm çalışma hastalarında standart  yüzey 12-lead EKG çekildi. QT aralığı, QTc aralığı, QRS süresi, PR aralığı, P dalgası ve QRS ekseni belirlendi. Posterior inen koroner arterin kökenine göre koroner dolaşım, sağ, sol ve dengeli (kodominant) koroner dominant olarak sınıflandırıldı.

Bulgular: 56 sağ dominant (% 42), 39 sol dominant (% 29) ve 38 kodominant (% 29) paternli 133 hasta vardı. Kodominant ve sağ dominant grup ile karşılaştırıldığında, QRS ekseni değeri sol dominant grupta anlamlı olarak daha yüksek bulundu (p˂0.05). Kodominant ve sağ dominant gruplar arasında QRS ekseni değerleri açısından anlamlı fark saptanmadı. Sol dominant grupta QRS ekseni (+30) - (+ 90) oranı, kodominant ve sağ dominant grup ile karşılaştırıldığında anlamlı derecede yüksek olduğu bulundu (p˂0.05). Kodominant ve sağ dominant gruplar arasında QRS ekseni (+30) - (+ 90) oranları arasında anlamlı bir fark gözlenmedi.

Sonuç: Bulgularımız QRS ekseninin koroner arter baskınlığı ile ilişkili olabileceğini düşündürmektedir.

Keywords

• Koroner arter baskınlığı,QRS ekseni

The relationship between coronary arterial dominance and the QRS axis

Abstract

Aim: Coronary artery dominance influences the amount and anatomic location of myocardium that is perfused by the left or right coronary circulation. However, the association between coronary arterial dominance and the QRS axis on 12-lead surface electrocardiography (ECG) was not investigated. The present study aims to evaluate the relationship between coronary arterial dominance and the QRS axis on ECG in patients without significant coronary artery and structural cardiac disease.

Material and Methods: Overall, 133 patients, without significant CAD and who met the inclusion criteria, participated in this study. A standard surface 12-lead ECGs were performed in all study patients. QT interval, QTc interval, QRS duration, PR interval, P wave and QRS axis were determined. Based on the origin of the posterior descending coronary artery, coronary circulation was categorised into left, right, and balanced coronary dominance.

Results: There were 133 subjects with 56 right dominant (42%), 39 left dominant (29%) and 38 codominant (29%) pattern. QRS axis value was found to be significantly higher in the left dominant group when compared with the codominant and right dominant group (p˂0.05). No significant difference was observed between the codominant and right dominant groups regarding QRS axis values. The axis of (+30)-(+90) ratio in the left dominant group was found to be significantly higher when compared with the codominant and right dominant group (p˂0.05). No significant difference was observed between the codominant and right dominant groups regarding the axis of (+30)-(+90) ratio.

Conclusion: Our findings suggested that the QRS axis may be related to coronary artery dominance

Keywords

• Coronary artery dominance,QRS axis

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