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Association of Duration of QRS complexes on ECG with Left Ventricular Diastolic
dysfunction in ST Elevation Myocardial Infarction
A. Diasmada1, M. Mahbubi1 , H. Mumpuni2, Erika Maharani3
1
Resident of Department Cardiology and Vascular, Faculty of Medicine Universitas Gadjah Mada – Dr.
Sardjito Hospital Yogyakarta, Indonesia
2
Echocardiography Division of Department Cardiology and Vascular, Faculty of Medicine Universitas
Gadjah Mada – Dr. Sardjito Hospital Yogyakarta, Indonesia
3
Arhytmia Division of Department Cardiology and Vascular, Faculty of Medicine Universitas Gadjah
Mada – Dr. Sardjito Hospital Yogyakarta, Indonesia
Background. The 12-lead electrocardiogram (ECG) is the most readily available noninvasive test for the
detection of cardiac disease. Several studies have shown that a normal 12-lead ECG in patients is a
relatively sensitive and specific marker for normal left ventricular (LV) function. In patients with LV
dysfunction and prior myocardial infarction, various electrocardiographic scoring systems have been
developed to estimate LV function, but their utility has been limited.
Aims. To investigate whether duration of QRS complex on ECG is related to diastolic dysfunction in acute
myocardial infarction patients.
Methods. This study population enrolling 87 patients with ST-elevation acute myocardial infarction. The
inclusion criteria were patients, 18-80 years old, Acute Myocardial Infarction onset < 12 hours, no history
of infarction, PCI and fibrinolitic. The exclusion criteria were documented atrioventicular block, chronic
heart failure, congenital heart disease, valvular heart disease, consumption of amiodaron,verapamil,
phonobarbital and propanolol, got cardiac resynchronization therapy. A prolonged QRS duration defined
as a QRS>0.10 s. Diastolic dysfunction is defined as restrictive, pseudonormal, and relaxation type of
diastolic dysfunction. Echocardiography was performed to all patients.
Results. The QRS duration shows that 26% patients had prolonged QRS on ECGs (pQRS + group). The two
groups were similar in term of baseline characteristics. and there were 74% who did not have pQRS on
their ECGs (pQRS - group). In patients with abnormal diastolic function, the median of QRS complex was
longer (89ms VS 80ms, p=0,603). However, QRS duration did not significantly differ between groups.
Conclusion. The presence of pQRS complexes on ECG didn’t predict diastolic dysfunction in patient ST
elevation myocardial infarction.
Keywords. Prolonged QRS, ST-elevation myocardial infarction, diastolic dysfunction