Fragmented QRS Complex in Acute Anterior Myocardial Infarction and Coronary Sinus Blood Flow: Is There any Relevance?

Patients with QRS fragmentation following myocardial infarction (MI) are at greater risk of cardiac death. Transthoracic echocardiography (TTE) can be used as a method for evaluating the coronary sinus blood flow (CSBF) and coronary sinus velocity time integral (CSVTI). The present study reports measurement of CSBF and CSVTI by TTE in 100 acute anterior MI cases, half of them with fragmented QRS. Methods Our study included 100 patients with acute anterior MI in whom CSBF and CSVTI were measured by the use of TTE. Fifty of all the patients had fragmented QRS complex and 50 patients were without fragmented QRS complex, while there was no difference in terms of LVEF in both groups of study. Results CSBF (303 ±126 ml/min vs. 258 ± 121 ml/min; p=0.001) and CSVTI (14.45 ± 2.85 ml vs.10.85 ±2.69 ml; p=0.003) were significantly lower in the acute anterior MI patients with fragmented QRS in comparison with the patients with acute anterior MI without fragmented QRS. Conclusions We conclude that CSBF and CSVTI can be measured by TTE in acute MI patients and these variables are reduced in acute anterior MI patients with fragmented.