Pagrindinis širdies ir kraujagyslių sistemos uždavinys – deguonies ir maisto medžiagų tiekimas. Deguonimi ir maisto medžiagomis kraujas aprūpina dirbančius raumenis ir kitus organus. Darbo tikslas – palyginti ištvermę lavinančių sportininkų ir nesportuojančiųjų širdies funkcinį parengtumo ypatybes taikant elektrokardiografijos metodą ir skirtingo kryptingumo fizinio krūvio mėginius. Uždaviniai: 1 - palyginti nesportuojančiųjų ir ištvermę lavinančių sportininkų ŠSD kaitos ypatybes atliekant pakopomis didėjantį krūvį veloergometru; 2 - palyginti nesportuojančiųjų ir ištvermę lavinančių sportininkų ŠSD kaitos ypatybes atliekant dozuoto krūvio mėginį; 3 - palyginti nesportuojančiųjų ir ištvermę lavinančių sportininkų ŠSD kaitos ypatybes atliekant maksimalaus anaerobinio krūvio mėginį; 4 – palyginti trijų skirtingų fizinio krūvio mėginių informacinės dimensijos reikšmes, kai elektrokardiografijos metodu vertinama funkcinio parengtumo ypatybės. Metodika. Buvo tirta 7 ištvermės rungčių atstovai lengvaatlečiai ir 16 nesportuojančių asmenų. Tiriamieji atliko tris fizinio krūvio mėginius: pakopomis didėjantį krūvį veloergometru; Rufje fizinio krūvio mėginį ir 30 - s vertikalaus šuoliavimo testą. Kompiuterine EKG registravimo ir analizės sistema „Kaunas-krūvis“ buvo registruojama EKG ir vertinama ŠŠD, JT intervalo, ST-segmento depresijos kaita atliekant krūvius ir pirmąsias tris atsigavimo minutes. Rezultatai ir išvados. Pakopomis didėjančio krūvio metu registruojant... [toliau žr. visą tekstą] / Cardiovascular system is the main physiological system determining physical working capasity or endurance. The main task of cardiovascular system to deliver the oxygen anf energy substrates to tisues and muscles as well. The purpors of this study was to compare functional peculiarities of cardiovascular system in endurance and non-sportsmans cohorts while performing various exercise tests. Objectives: 1 - to compare the cardiovascular reactions in endurance and non-sportsmans cohorts while performing graded exercise stress (bycycle ergometry); 2 – to compare the cardiovascular reactions in endurance and non-sportsmans cohorts while performing dosed aerobic exercise test; 3 – to compare the cardiovascular reactions in endurance and non-sportsmans cohorts while performing maximal anaerobic workload (30-s vertical jumps test); 4 – to compare the informativeness of aplyed exercise protocols for assessment of cardiovascular reactions in endurance and non-sportsmans cohorts. Methods. The participant fo this study was 7 endurance athletes and 16 non-sportsman. Subjects performed three exercise tests: graded exercise stress (bycycle ergometry); dosed aerobic exercise test (Roufier Test) maximal anaerobic workload (30-s vertical jumps test). A computerized ECG analysis system "Kaunas-load" was recorded ECG and assessed FCU, JT interval, ST-segment depression changes in workloads and the first three minutes of recovery. Results and Conclusions. The registration of ECG during the... [to full text]

Atlikti tyrimai, kuriuose nagrinėjamas mitybos apribojimo poveikis širdies ir kraujagyslių sistemai (ŠKS). Taip pat nagrinėjami kognityviniai pokyčiai bei funkcinių organizmo sistemų ir jas atspindinčių rodiklių pasikeitimai. Atliktas darbas papildė žinias apie trumpalaikio badavimo įtaką sveikiems asmenims, fiziškai aktyviems ir neaktyviems, taip pat turintiems viršsvorį bei normalų kūno svorį. Tyrimui pasirinktas integralusis vertinimo modelis, leidžiantis įvertinti ŠKS funkcinę būklę sukuriant specialias sąlygas – badavimą. Ši naudojama mokslininkų metodika nusako tarpusavyje susijusias kelias pagrindines holistines organizmo sistemas, t.y. vykdomąją (V), aprūpinamąją (A) bei reguliuojamąją (R). Norėdami ištirti šių sistemų tarpusavio ryšius po trumpalaikio badavimo nagrinėjome dar mažai žinomas, tačiau įvairiuose darbuose fizinio krūvio metu nagrinėtas sąsajas. Po atlikto tyrimo stebėtos tarparametrinės sąsajos akivaizdžiai patvirtino, kad trumpalaikis badavimas žmogaus organizmą veikia teigiamai, didėja organizmo funkcionavimo kompleksiškumas, t.y. reaguojant vienai sistemai tuo pačiu metu ir adekvačiau sureaguoja ir kita sistema. Širdies ir kraujagyslių sistemos tyrimų rezultatai po trumpalaikio badavimo įrodė, kad ramybės bei krūvio metu skirtingose grupėse ŠKS funkciniai rodikliai yra reikšmingai veikiami, sveikatos tausojimo kryptimi. Taikant integraliojo vertinimo modelį atsiveria naujos erdvės tyrimams papildant žinias apie žmogaus organizmo reakcijas į... [toliau žr. visą tekstą] / The studies that analysed the effects of nutrition limitation on the heart autonomic mechanism mostly focused on the changes of long-term fasting. The also examines changes in cognitive and functional systems of the body and are them of indicators reflecting changes. The study supplemented knowledge of the effect of short-term fasting on healthy, physically active and inactive individuals as well as overweight and individuals with normal body weight. The novelty of our study is that the integrated assessment model that allows to evaluate the CVS state under special conditions – fasting was chosen. This method used by researchers describes the basic body systems that are interrelated, i.e. executive (E), supplying (S) and regulatory (R). To investigate the relationships between these systems after short-term fasting, we analysed the associations during workload that were still little known but investigated in different studies. The test proved that associations observed between parameters showed that short-term fasting affected the human body in a complex way, response of one system triggered an immediate response of the other system. The study results of the cardiovascular system after short-term fasting proved that cardiovascular parameters at rest and during workload in different groups were affected by the direction of health preservation. Integrated assessment model opens new research fields that supplement knowledge of body‘s responses to altering conditions.

<p>Metadon je sintetski agonist opijatnih receptora koji se primenjuje u sklopu supstitucione terapije opijatnih zavisnika metadonom (STM) i u terapiji hroničnog bola. Dugoročna primena STM je praćena blagim, uglavnom prolaznim, neželjenim delovanjima. Međutim, metadon pripada grupi lekova koji mogu da prouzrokuju prolongaciju korigovanog QT intervala (QTc) u elektrokardiogramu (EKG-u) i povećaju rizik za nastanak potencijalno fatalnih aritmija tipa torsades de pointes. Opijatni zavisnici metadon najče&scaron;će koriste u kombinaciji sa benzodiazepinima, i ova kombinacija lekova predstavlja faktor rizika za nastanak smrtnog ishoda. Iako je najveći broj lekara upoznat sa rizikom za razvoj respiratorne depresije prilikom primene opijata u kombinacji sa benzodiazepinima, velika studija otkriva da su ventrikularne aritmije i srčani zastoj najče&scaron;će prijavljivana neželjena delovanja metadona, primenjenog u kombinaciji sa benzodiazepinima. Ciljevi ovoga radu su da se analizom smrtnih slučajeva povezanih sa upotrebom metadona (MRDs) tokom desetogodi&scaron;njeg perioda na teritoriji Vojvodine i sprovođenjem kliničkog ispitivanja kod opijatnih zavisnika na STM proceni kardiolo&scaron;ka bezbednost primene metadona, posebno u kombinaciji sa benzodiazepinima. Sprovedena je retrospektivna studija za određivanje karakteristika MRDs na teritoriji Vojvodine, kao i kliničko ispitivanje u kome su učestvovali opijatni zavisnici koji počinju sa STM. Snimanje EKG-a (za izračunavanje QTc intervala) i uzorkovanje krvi (za određivanje koncentracije metadona i diazepama i vrednosti troponina) je sprovedeno kod svih učesnika istraživanja u 5 vremenskih tačaka (pre početka primene STM, 8. i 15. dana i nakon 1. i 6. meseca primene STM). Koncentracije metadona i diazepama u serumu su određivane metodom tečne hromatografije sa masenom spektrometrijom (LC-MS). U Vojvodini je zapažena rastuća tendencija MRDs, ali ni jedan od umrlih nije bio na STM, i najverovatnije su samoinicijativno koristili metadon i benzodiazepine. Patohistolo&scaron;ki nalaz na srcu može govoriti u prilog kardiotoksičnosti metadona i njegove kombinacije sa benzodiazepinima, pogotovo kod slučajeva sa pronađenim akutnim miokardijalnim o&scaron;tećenjem. &Scaron;to se tiče hroničnih promena na srcu, ne postoji mogućnosti da se potvrdi niti opovrgne uloga psihostimulanasa. Detektovane koncentracije metadona i diazepama kod MRDs su bile u opsegu terapijskih (&lt;1 &mu;g/ml). Poredeći socio-demografske karakteristike opijatnih zavisnika koji su počeli sa STM u ovom istraživanju sa podacima iz sličnih studija sprovedenih &scaron;irom sveta, zapažena je sličnost u pogledu velikog broja karakteristika. Srednje doze metadona 8., 15. dana i nakon 1. i 6. meseca primene STM su bile 40,23&plusmn;17,11 mg, 47,11&plusmn;16,79 mg, 50,00&plusmn;17,55 mg i 78,63&plusmn;18,14 mg, dok su srednje doze diazepama u istim vremenskim tačkama bile 35,92&plusmn;10,47 mg, 33,89&plusmn;9,23 mg, 28,33&plusmn;11,55 mg i 28,12&plusmn;11,67 mg. Srednje koncentracije metadona su u posmatranim tačkama ispitivanja iznosile 153,44&plusmn;111,51 ng/ml, 157,43&plusmn;112,39 ng/ml, 176,77&plusmn;118,56 ng/ml i 342,86&plusmn;181,54 ng/ml, dok su srednje koncentracije diazepama bile 923,00&plusmn;537,89 ng/ml, 923,76&plusmn;739,96 ng/ml, 560,74&plusmn;436,72 ng/ml i 1045,32&plusmn;932,72 ng/ml. Dužina QTc intervala pre primene STM je bila 411,87&plusmn;27,22 ms, tj. 414,64&plusmn;29,38 ms 8. dana STM, 416,97&plusmn;26,39 15. dana, i 425,20&plusmn;17,71 ms nakon 1. meseca tj. 423,50&plusmn;14,72 ms nakon 6. meseca primene STM. Pokazan je statistički značajan porast dužine QTc intervala nakon 1. i nakon 6. meseca primene STM u odnosu na vrednost pre primene STM, kako u grupi svih ispitanika, tako i u podgrupi mu&scaron;kog pola. Pokazano je postojanje statistički značajne korelacije između koncentracije metadona i dužine QTc intervala nakon 15. dana, 1. i 6. meseca primene STM, kako kod svih ispitanika, tako i u podgrupi mu&scaron;kog pola. Ova korelacija ostaje statistički značajna i ukoliko se uključe i drugi faktori &ndash; koncentracija diazepama i dužina perioda upotrebe heroina, kod svih ispitanika i u podgrupi mu&scaron;kog pola nakon 15 dana i mesec dana primene STM, kao i u podgrupi mu&scaron;kog pola nakon 6. meseca STM. Iako nijedan pacijent nije prijavio neko neželjeno delovanje metadona na nivou kardiovaskularnog sistema, najveći broj pacijenata oba pola se nakon prvog meseca primene STM žalio na pojačano znojenje i opstipaciju. Koncentracije metadona i diazepama u uzorcima krvi kod MRDs se nalaze u rasponu koncentracija ovih lekova u krvi ispitanika koji su učestvovali u prospektivnoj studiji. Trećina umrlih je imala samo znake akutnog o&scaron;tećenja srca, dok do porasta troponina i vrednosti QTc intervala preko 500 ms nije do&scaron;lo ni kod jednog ispitanika iz prospektivne studije. Potrebno je sprovesti dalja istraživanja sa ciljem razja&scaron;njenja moguće uloge benzodiazepina u povećanju kardiotoksičnosti metadona kod opijatnih zavisnika na STM.</p> / <p>Methadone is a synthetic agonist of opioid receptors which is used in methadone maintenance tratment (MMT) of opiate addicts as well as in the treatment of chronic pain. A long-term use of MMT is followed by mild, mostly transient, adverse effects. However, methadone belongs to a group of medicines which can provoke a prolongation of QTc (corrected QT) interval in electrocardiogram (ECG) and thus increase the risk from the development of potentially fatal arrhythmias &ndash; torsades de pointes. Moreover, methadone is widely associated with benzodiazepines use in heroin addicts, and this combination is considered as a risk factor for lethal outcome. Despite the fact that most of health care professionals are aware of possible respiratory depressant effect of methadone and benzodiazepines co-administration, recently published data reveal that ventricular arrhythmia and cardiac arrest are currently the most frequent adverse event attributed to methadone and benzodiazepine co-medication. The aim of this study is to assess cardiac safety of methadone use, especially in combination with benzodiazepines, by analyzing characteristics of methadone-related deaths (MRDs) during 10-year period as well as by conducting a clinical trial among opiate addicts in MMT. A retrospective study to determine the characteristics of MRDs in Vojvodina, as well as a clinical trial in which participated opiate addicts at the start of MMT were performed. ECG (to calculate QTc interval) and blood sampling (to determine methadone and diazepam concentrations and troponin values) were performed in all study participants at five time points (before the introduction of MMT, on 8th, on 15th day, after 1 and 6 months of MMT). Methadone and diazepam concentrations in serum were determined by using liquid chromatography-mass spectrometry (LC-MS). An increasing tendency of MRDs was observed in the region of Vojvodina, but none of the victims were under healthcare professionals&rsquo; control, and, most commonly, they used methadone and benzodiazepines, on their own initiative. Pathohistological findings in the heart in MRDs might support cardiac adverse effects of methadone and its combination with benzodiazepines, especially in cases with acute myocardial damage. As for the chronic heart changes, we can neither confirm nor exclude the role of psychostimulants. Detected concentrations of methadone and diazepam were in therapeutic range (&lt;1 &mu;g/ml). Comparing socio-demographic characteristics of opiate addicts who started with MMT in this study with data from similar studies conducted worldwide, the similarity in terms of large number of features was observed. The mean methadone dose on the 8th, 15th days, and after 1 and 6 months of MMT was 40.23&plusmn;17.11 mg, 47.11&plusmn;16.79 mg, 50.00&plusmn;17.55 mg and 78.63&plusmn;18.14 mg, respectively, while the mean diazepam dose at the same time points was 35.92&plusmn;10.47 mg, 33.89&plusmn;9.23 mg, 28.33&plusmn;11.55 mg and 28.12&plusmn;11.67 mg, respectively. The mean methadone concentration at observed time points was 153.44&plusmn;111.51 ng/ml, 157.43&plusmn;112.39 ng/ml, 176.77&plusmn;118.56 ng/ml and 342.86&plusmn;181.54 ng/ml, respectively, while the mean diazepam concentration was 923.00&plusmn;537.89 ng/ml, 923.76&plusmn;739.96 ng/ml, 560.74&plusmn;436.72 ng/ml and 1045.32&plusmn;932.72 ng/ml, respectively. The length of QTc interval before the introduction of MMT was 411.87&plusmn;27.22 ms, 414.64&plusmn;29.38 ms on the 8th day of MMT, 416.97&plusmn;26.39 on the 15th day of MMT, after 1 month of MMT 425.20&plusmn;17.71 ms and after 6 months of MMT 423.50&plusmn;14.72 ms. There was a statistically significant increase in the length of QTc interval after 1 and 6 months of MMT in comparison to the value before the application of MMT, within the whole group of patients and in the subgroup of men. A statistically significant correlation between the concentration of methadone and QTc interval length after 15 days, 1 and 6 months of MMT, both in the whole group and in the subroup of men was observed. The correlation remained statistically significant if the other factors, such as concentration of diazepam and the length of heroin use, were included, in all patients and in the subgroup of men after 15 days and one month of MMT as well as in the subgroup of men after 6 months of MMT. Although none of the patients reported any cardiac adverse effect of methadone, the majority of them complained of sweating and constipation after the first month of MMT. Concentrations of methadone and diazepam in blood samples in MRDs were within the range of concentrations of these drugs in blood of patients who participated in the prospective study. In one third of MRDs only signs of acute myocardial damage were detected, while an increase in troponin values and the length of QTc interval over 500 ms did not occur in any patient in the prospective study. Further studies could clarify the possible role of benzodiazepines in the increasing cardiotoxicity of methadone in opiate addicts in MMT.</p>

<p>Ishemijska bolest srca najče&scaron;će nastaje kao posledica razvoja aterosklerotskih promena na koronarnim krvnim sudovima koji dovode do suženja lumena i posledičnog pada protoka arterijske krvi u području vaskularizacije. Akutni oblik koronarne bolesti koji zahteva hitnu primenu reperfuzione terapije je ST elevirani infarkt miokarda. EKG ima veliki značaj u postavljanju dijagnoze ali i u proceni uspe&scaron;nosti same reperfuzije. &Scaron;irina QRS kompleksa jedan je od EKG parametara čija dinamika promena može ukazati na uspe&scaron;nost pPKI i veličinu infarktne zone. Evaluacija &scaron;irine QRS kompleksa kao prediktora veličine infarkta miokarda i reperfuzije nakon pPKI kod pacijenata sa STEMI. Ispitivanje je sprovedeno kao prospektivna, opservaciona klinička studija na Klinici za kardiologiju, Instituta za kardiovaskularne bolesti Vojvodine u periodu od januara 2016. do decembra 2018. godine. U isptivanje je uključeno 200 pacijenata sa STEMI kod kojih je urađena pPKI. Na osnovu dužine trajanja tegoba formirane su dve grupe od po 100 pacijenata. Grupa A kod kojih je totalno ishemijsko vreme bilo &lt;6h i grupa B kod kojih je totalno ishemijsko vreme između 6 i 12h. . Sprovedeno je EKG praćenje radi procene &scaron;irine QRS kompleksa intrahospitalno (pre procedure, odmah nakon pPKI kao i posle 1h i 72h) i na dve vizite ambulantno tokom &scaron;estomesečnog praćenja (nakon mesec dana i &scaron;est meseci). Ehokardiografija je urađena kod svih pacijenata intrahospitalno i na &scaron;estomesečnom ambulantnom pregledu. &Scaron;irine QRS kompleksa su korelirane sa rezultatima interventne procedure procenjene TIMI protokom i TMPG, dinamikom kardiospecifičnih enzima i ehokardiografskim nalazima. U istraživanje je uključeno 71% mu&scaron;karaca i 29% žena, prosečna starost uzorka iznosila je 60.6&plusmn;11.39. Dužina trajanja tegoba značajno se razlikovala između grupa. U grupi A tegobe su trajale prosečno 120 minuta (90-180), dok su u grupi B trajale 420 minuta (360-600) (p&lt;0.0005). DTB nije se značajno razlikovao, 42 minuta (31-54.5) u odnosu na 40.5 minuta (34.5-55) (p=0.818). Prosečna &scaron;irina QRS kompeksa na EKG-u pre pPKI nije se značajno razlikovala između grupa, 100 msec (90-110) u odnosu na 100 msec (93-110) (p=0.308). Nakon reperfuzije uočena je značajna razlika u &scaron;irini QRS kompleksa između grupa na svim intrahospitalnim kao i EKG-ima načinjenim tokom perioda praćenja. QRS kompleks je &scaron;iri kod pacijenata iz grupe B (p&lt;0.0005). Pacijenti iz grupe A koji su imali prohodnu infarktnu arteriju sa TIMI 3 protokom pre implantacije stenta imali su značajno uži QRS kompleks na incijilanom EKG-u u odnosu na pacijente kod kojih je IRA bila sub/okludirana sa TIMI protokom &le;2 (p=0.001). U grupi B prohodna infarktna arterija sa TIMI 3 protokom nije značajno uticala na &scaron;irinu QRS kompleksa na inicijalnom EKG-u (p=0.144). Na EKG-ima nakon procedure QRS kompleks bio je značajno &scaron;iri kod pacijenata kod kojih je TIMI protok &le;2, ali samo za grupu pacijenata koja se javila unutar 6h od početka tegoba (p=0.001). QRS kompleks kod pacijenata koji su se javili nakon 6h od početka tegoba jeste bio uži, ali bez statistički značajne razlike (p=0.336). Pearsonovim testom registrovano je postojanje negativne korelacije &scaron;irine QRS kompleksa i istisne frakcije leve komore, ali i pozitivne korelacije sa WMSI i indeksiranim end sistolnim i end dijastolnim volumenom. ROC analizom pokazano je da ukoliko je QRS kompleks &scaron;iri od 89 msec nakon mesec dana, 8.5 puta je veći rizik od snižene EF na &scaron;estomesečnoj kontroli (p&lt;0.0005, AUC=0.808, cut-off=89msec.). ROC analiza pokazala je i da ukoliko je QRS kompleks &scaron;iri od 99msec 1h nakon procedure, 5 puta je veći rizik od pojave MACE (p&lt;0.0005, AUC=0.744, cut-off=99msec). Izvedena su dva matematička modela zasnovana na &scaron;irini QRS kompleksa koja vr&scaron;e predikciju snižene EF i pojave MACE tokom perioda praćenja. &Scaron;irina QRS kompleksa je pokazatelj reperfuzije kod pacijenata sa STEMI kod kojih se načini revaskularizacija unutar 6h od nastanka tegoba. &Scaron;irina QRS kompleksa mesec dana nakon STEMI predstavlja nezavisni prediktor snižene EF. Pro&scaron;irenje preko 89msec 8.5 povećava rizik od snižene EF. &Scaron;irina QRS kompleksa jedan sat nakon pPKI predstavlja nezavisni prediktor za MACE. Pro&scaron;irenje preko 99msec 5 puta povećava rizik od neželjenog kardiolo&scaron;kog događaja. Izvedena su dva matematička modela koja koriste &scaron;irinu QRS kompleksa i sa visokom precizno&scaron;ću vr&scaron;e predikciju MACE-a, odnosno snižene EF nakon &scaron;est meseci.&nbsp;</p> / <p>Ischemic heart disease most commonly occurs as a result of the atherosclerotic changes in the coronary vessels that lead to the narrowing of the lumen and consequent fall in arterial blood flow in the vascularization area. An acute form of coronary artery disease requiring immediate reperfusion therapy is ST-elevation myocardial infarction. The ECG is of great importance not only in making the diagnosis but also in evaluating the success of the reperfusion itself. The duration of the QRS complex is one of the ECG parameters whose change in dynamics can indicate the success of pPCI as well as the size of the infarct zone. Evaluation of the width of the QRS complex as a predictor of myocardial infarction size and reperfusion after pPCI in patients with STEMI. The study was conducted as a prospective, observational clinical study at the Cardiology Clinic of the Institute of Cardiovascular Diseases of Vojvodina between January 2016 and December 2018. The study included 200 patients with STEMI in whom pPCI was performed. Based on the length of discomforts two groups with 100 patients were formed. Group A had a total ischemic time &lt;6h and the total ischemic time in group B was between 6-12h. To assess the duration of the QRS complex, the ECG monitoring was performed intrahospital (before the procedure, immediately after pPCI as well as 1h and 72h after the procedure) and on two outpatient visits during the six-month follow-up period (after one month and six months). Echocardiography was performed in all patients intrahospital and at a six-month outpatient visit. The duration of the QRS complex correlated with the results of the interventional procedure that was evaluated by the TIMI flow and TMPG, the dynamics of cardiospecific enzymes and echocardiography findings. The survey included 71% of men and 29% of women with an average age of 60.6 &plusmn; 11.39. The duration of the discomforts varied significantly between the groups. In group A the discomforts lasted 120 minutes in an average (90-180), while they lasted 420 minutes in group B (360-600) (p &lt;0.0005). DTB did not differ significantly, 42 minutes (31-54.5) versus 40.5 minutes (34.5-55) (p = 0.818). The average duration of the QRS complex on the ECG before pPCI did not differ significantly between the groups, 100 msec (90-110) versus 100 msec (93-110) (p = 0.308). After the reperfusion, a significant difference in the duration of the QRS complex was observed between the groups at all intrahospital ECGs and the ECGs performed during the follow-up period. The QRS complex was broader in group B patients (p &lt;0.0005). Group A patients who had a patent infarct artery with TIMI 3 flow before the stent implantation had a significantly narrower QRS complex on the initial ECG compared to the patients whose IRA was sub / occluded with TIMI flow &le;2 (p = 0.001). In group B, the patent infarct artery with TIMI 3 flow did not significantly affect the duration of the QRS complex at the initial ECG. (p = 0.144). At the post-procedural ECGs the QRS complex was significantly broader in patients with TIMI flow &le;2, but only in the group of patients who arrived within 6 h from the onset of discomforts (p = 0.001). The QRS complex in patients who arrived 6 h after the onset of discomforts was narrower but without statistically significant difference (p = 0.336). The Pearson test registered the existence of a negative correlation of the QRS complex width and the left ventricular ejection fraction, but also a positive correlation with the WMSI and index end-systolic and end-diastolic volumes. The ROC analysis showed that if the QRS complex was wider than 89 msec after one month, there was an 8.5 times higher risk of decreased EF at the six-month control examination (p &lt;0.0005, AUC = 0.808, cut-off = 89msec.). The ROC analysis also showed that if the QRS complex was wider than 99msec 1h after the procedure, there was a 5 times higher risk of MACE (p &lt;0.0005, AUC = 0.744, cut-off = 99msec). Two mathematical models based on the width of the QRS complex were derived that predicted the lowered EF and the occurrence of MACE during the monitored period. The width of the QRS complex is an indicator of reperfusion in patients with STEMI who undergo revascularization within 6 hours from the onset of discomforts. The width of the QRS complex one month after STEMI is an independent predictor of decreased EF. Broadening over 89msec increases the risk of lowered EF for 8.5 times. The width of the QRS complex one hour after pPCI represents an independent predictor of MACE. Broadening over 99msec increases the risk of an adverse cardiac event 5 times. Two mathematical models have derived that use the width of the QRS complex and predict MACE with high precision as well as reduced EF after six months.</p>