RANI PREDIKTORI RIZIKA ZA NASTANAK IZNENADNE SRČANE SMRTI POSLE INFARKTA MIOKARDA: REZULTATI ISPITIVANJA 881 BOLESNIKA

Abstract

INTRODUCTION It has been shown that depolarization disorders, autonomic dysfunction, and systolic dysfunction of the left ventricle are associated with sudden cardiac death after myocardial infarction.

OBJECTIVE The objective of study was to examine the prognostic value of the most important predictors in the first week after myocardial infarction.

METHOD Study included 881 patients who were followed up from 1 to 60 months. During the first week after myocardial infarction, following examination were performed: ECG with standard leads and X, Y, Z orthogonal leads, vectorcardiogram, QT interval, late potentials, short-time spectral analysis of RR variability, nonlinear (Poincaré plot) analysis and echocardiogram.

RESULTS In univariate analysis, the following parameters measured on the first day were important predictors of sudden cardiac death: lower LF/HF ratio(<1.5) (p=0.000), T wave inversion in X lead (p=0.000), high P wave in D2 lead (p=0.030), and diminished systolic function (p=0.000). In multivariate analysis, the following parameters were significant risk predictors: T wave inversion in X lead, lower LF/HF ratio, positive late potentials and the left ventricle systolic dysfunction.

CONCLUSION The parameters of the left ventricle systolic disfunction with sympathicovagal imbalance and electric instability are the key risk predictors in the first few days after myocardial infarction.

Keywords: risk factors; myocardial infarction; late potentials; RR variability