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    Association of Fragmented QRS Complex with Myocardial Reperfusion in Acute ST-Elevated Myocardial Infarction
    (WILEY-BLACKWELL, 2013) Erdem, Fatma Hızal; Tavil, Yusuf; Yazıcı, Hüseyin; Aygül, Nazif; Abacı, Adnan; Boyacı, Bülent
    In this study, we aimed to evaluate the relationship between TIMI myocardial perfusion (TMP) grade, as an indicator of myocardial reperfusion, and fragmented QRS (fQRS) in standard 12-lead electrocardiogram. Also, we evaluate fQRS is an additional indicator of myocardial reperfusion. One hundred patients admitted with first STEMI to Coronary Intensive Care Unit and who were used thrombolytic therapy was included in this retrospective study. Standard 12-lead electrocardiogram records of patients simultaneous with coronary angiography (second day) were assessed and analysed for the presence of fQRS. Also, coronary angiography images were analyzed to identify the infarct related artery, TIMI grade of infarct related artery and TMP grade of infarct related artery. The patients with fQRS demonstrated a significantly lower TMP grade, TIMI grade and ejection fraction compared with the non-fQRS patients (P = 0.004, P = 0.003, P = 0.02 respectively). The patients with inadequate myocardial reperfusion demonstrated a significantly higher fQRS compared with the adequate myocardial reperfusion patients. (56.9% versus 23.5%, P = 0.002 respectively). On correlation analysis, there was a significant negative correlation between fQRS and left ventricular ejection fraction (r = -232, P = 0.02) TMP grade and adequate myocardial reperfusion (TMP 3) showed significant negative correlation with fQRS (r = -0.370, P = 0.000; r = -0.318, P = 0.001 respectively). Presence of fragmented QRS in STEMI patients was associated with inadequate myocardial reperfusion and it can be used as a simple, noninvasive parameter to evaluate myocardial reperfusion. Ann Noninvasive Electrocardiol 2013;18(1):69-74
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    The Relationship Between Admission Hemoglobin Level and and Left Ventricular Systolic Functions in Patients With First ST-segment Elevated Myocardial Infarction
    (2010) Şen, Nihat; Yazıcı, Hüseyin Uğur; Tavil, Yusuf; Poyraz, Fatih; Turfan, Murat; Aygül, Nazif; Vatankulu, Mehmet Akif; Özdoğru, İbrahim; Abacı, Adnan
    Objectives: The goal of this study was to evaluate the relationship between admission hemoglobin levels and left ventricular systolic functions in patients admitted with first ST-segment elevated myocardial infarction (STEMI). Study design: The study was conducted prospectively in three centers in 483 consecutive patients (402 men, 81 women; mean age 56.5±11.2 years; range 24 to 74 years) with first STEMI. All patients were evaluated by echocardiography after a mean of 2.4 days of admission. Evaluation of left ventricular systolic functions included measurements of ejection fraction (EF), wall motion score index (WMSI), and tissue Doppler S wave velocities at four different localizations (anterior, inferior, lateral, posterior septum). Hemoglobin levels were measured within one hour of admission. Anemia was defined according to the World Health Organization criteria (hemoglobin <13.0 g/dl in men and <12.0 g/dl in women). Echocardiographic characteristics of the patients with and without anemia were compared. Results: Anemia was detected in 67 patients (13.9%). There were no significant differences between patients with and without anemia with respect to left ventricular end-systolic and end-diastolic diameters, wall thickness, WMSI, and EF. The mean EF in the anemic group (47.5%) was lower than that of the patients without anemia (48.5%), but this difference was not significant. All Sm velocities were lower in the anemic group, but only septal mitral annular Sm velocity reached statistical significance (p0.048). There was no correlation between hemoglobin levels and EF (r0.027, p0.55). Conclusion: Our findings suggest that mild to moderate anemia has no deleterious effect on systolic function in patients with first STEMI.