An Investigation into the Relationship between N-Terminal Pro B-Type Natriuretic Peptide (NT-proBNP) and Fragmented QRS in Patients with Chronic Heart Failure

Abstract

BACKGROUNDHeart failure is a clinical syndrome characterized by a constellation of symptoms and signs often caused by a structural and/or functional cardiac abnormality resulting in reduced cardiac output and/or elevated intracardiac pressures. Fragmented QRS (fQRS) complex is associated with fibrosis or myocardial scar in patients with structural heart disease. Patients, especially cardiologists, are particularly concerned about heart failure in people suffering from dyspnoea. The prevalence of this disease is rising in industrial countries. The relationship between NT-proBNP and fragmented QRS in patients with chronic heart failure was investigated in this study. METHODSThe population included 42 patients suffering from chronic heart failure. fQRS was described as ≥1 additional deflection, including the peak of the R-wave or the nadir of S-wave, in at least two continuous leads. According to the absence of fQRS [fQRS (-)] or presence of fQRS (n= 22 and n= 20, respectively), the patients were assigned to two groups. The statistical package for social sciences (SPSS, version 22) was used to analyse the data. Furthermore, the normality of the data was investigated by the Shapiro-Wilk test. The chi-square test and independent t-test were used to compare the variables. RESULTS42 patients (18 women and 24 men) aged 54.78±6.43 years participated in this study. Given the fQRS at hospitalization, the patients were assigned to fQRS (-) (n= 20) and fQRS (+) (n= 22) groups. The results showed that NT-proBNP level was significantly lower in fQRS (-) group (p < 0.001), compared to fQRS (+) group. There was a significant difference between the two groups in terms of NYHA, blood pressure, hypertension, diabetes and hyperlipidaemia. The groups were compared in terms of demographic characteristics, angiography including hyperlipidaemia, and history of cardiovascular diseases. The fQRS (+) group exhibited a higher proportion of hyperlipidaemia (63.40%), troponin I (34.33 ± 21.87) and ) than the fQRS (-) group. CONCLUSIONSThe results showed a significant relationship between fQRS and the higher levels of NT-proBNP. The fQRS was associated with increased NT-proBNP and pronounced LV end-diastolic pressure in heart failure patients.

Predictive role of fragmented QRS in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

“…In our study, fQRS on ECG was negatively associated with a LVEF, similar to previously reported data (13), but contrary to data by Mehmat et al (14) and Sukru et al (15). Likewise, fQRS was associated with higher NT-proBNP at 24 hours and 48 hours, similar to the previously reported data (15). These findings corroborate with the fact that fQRS is associated with myocardial scar.…”

“…In univariate analysis ( 0.04 CI -confidence interval, fQRS -fragmented QRS, LVEF -left ventricular ejection fraction, NT-proBNP -Nterminal pro-brain natriuretic peptide, OR -odds ratio Several studies and meta-analyses have found fQRS to be associated with adverse short and long-term outcomes including HF, TVR, and mortality. In our study, fQRS on ECG was negatively associated with a LVEF, similar to previously reported data (13), but contrary to data by Mehmat et al (14) and Sukru et al (15). Likewise, fQRS was associated with higher NT-proBNP at 24 hours and 48 hours, similar to the previously reported data (15).…”