Association of fragmented QRS complexes on ECG with left ventricular diastolic function in hypertensive patients

Kadı, Hasan; Demir, Ayşe Kevser; Ceyhan, Köksal; Damar, İbrahim Halil; Karaman, Kayıhan; Zorlu, Çağrı

doi:10.5543/tkda.2015.04495

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…This condition may be related to impaired diastolic functions. Indeed, higher incidence of impaired diastolic functions has been previously demonstrated in hypertensive patients with established fQRS …”

Section: Discussionmentioning

confidence: 88%

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Presence of fragmented QRS is associated with increased epicardial adipose tissue thickness in hypertensive patients

Bekar¹,

Kalçık²,

Çeli̇k

et al. 2019

J of Clinical Ultrasound

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Background Epicardial adipose tissue (EAT) is a cardiometabolic risk factor, and its possible relationship with hypertension has been reported previously. Fragmented QRS (fQRS) detected on electrocardiography (ECG) has been demonstrated to be a marker of myocardial fibrosis. In this study, we aimed to investigate the relationship between the thickness of EAT, and presence of fQRS in hypertensive patients. Methods Consecutive patients who were diagnosed with hypertension were included in the study. ECG and transthoracic echocardiography (TTE) were performed to all patients. fQRS was defined as additional R′ wave or notching/splitting of S wave in two contiguous ECG leads. Thickness of EAT was measured by TTE. Results This study enrolled 69 hypertensive patients with fQRS on ECG and 45 hypertensive patients without fQRS as the control group. Age (P = .869), and gender distribution (P = .751) were similar in both groups. Left atrial diameter (P = .012), interventricular septal thickness (P < .001), posterior wall thickness (P < .001), left ventricular ejection fraction (P = .009), left ventricular mass (P = .006), left ventricular mass ındex (P = .014), left ventricular hypertrophy (P = .003), and EAT thickness (P < .001) were found to be significantly increased in patients with fQRS. In multivariate analysis, among these variables only EAT was observed to be an independent predictor of fQRS (odds ratio:3.306 [95% confidence interval, 0.030‐0.118], P = .001). Conclusion A significant association exists between the presence of fQRS and EAT thickness in hypertensive patients. The presence of fQRS, just as EAT thickness, may be used as a cardiometabolic risk factor in hypertensive patients.

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Section: Discussionmentioning

confidence: 88%

“…Indeed, higher incidence of impaired diastolic functions has been previously demonstrated in hypertensive patients with established fQRS. 15 EAT is localized around heart, and coronary arteries, without any interposed fascial tissue. Therefore, EAT can affect these anatomical structures directly.…”

Section: Discussionmentioning

confidence: 99%

Presence of fragmented QRS is associated with increased epicardial adipose tissue thickness in hypertensive patients

Bekar¹,

Kalçık²,

Çeli̇k

et al. 2019

J of Clinical Ultrasound

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“…Myocardial infarction markers test time: at the first 3 days, they were tested once every 4 to 12 hours, including admission immediate, pre‐PCI and post‐PCI, they were tested once a day 3 days later, and record the results of all myocardial infarction markers and find the highest value. In addition, the occurrence of complications during PCI and major adverse cardiac events (MACEs) during hospitalization and 12 months were recorded, including cardiogenic shock, no‐reflow, stent thrombosis (ST), target vessel revascularization (TVR), target lesion revascularization (TLR), recurrent unstable angina pectoris (rUAP), all‐cause death, congestive heart failure (CHF) and cerebral ischemic stroke. The results of CAG were interpreted by two experienced cardiologists.…”

Section: Methodsmentioning

confidence: 99%

“…Outcome variables: All patients were followed up clinically by telephone contact or office visit. MACEs were defined as cardiogenic shock, no‐reflow, ST, TVR, TLR, rUAP, all‐cause death, chronic heart failure, and cerebral ischemic stroke . Angiographic success was defined as a final residual stenosis of <30% with TIMI grade 3 flow or improvement in flow as compared with the diagnostic angiogram.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, there has been a shift in the literature towards finding novel electrocardiogram (ECG) changes, which are highly suggestive of total coronary artery occlusion, but lack ST‐elevation in contiguous leads . These ST‐elevated myocardial infarction (STEMI)‐equivalents include delayed activation wave (N wave, notch in terminal QRS wave complex II, III, aVF, or I, aVL).…”

Section: Introductionmentioning

confidence: 99%

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Non‐ST‐elevated myocardial infarction with “N” wave on electrocardiogram and culprit vessel in left circumflex has a risk equivalent to ST‐elevated myocardial infarction

Yang

Chen

Liu

et al. 2020

Clinical Cardiology

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Background: It was found that delayed activation wave often appeared in terminal QRS wave in non-ST-elevated myocardial infarction (NSTEMI) with culprit vessel in left circumflex artery (LCX), yet little is known about the similarities among non-"N"-wave non-STelevated myocardial infarction (N-NSTEMI) and ST-elevated myocardial infarction (STEMI). Hypothesis:In AMI patients with the culprit vessel in LCX, "N" wave NSTEMI has a risk equivalent to STEMI.Methods: All 874 patients admitted to were included and whose coronary angiography (CAG) indicated the culprit vessel in LCX. Patients were divided into three groups: ST-elevated myocardial infarction group (STEMI group, n = 322), "N" wave non-ST-elevated myocardial infarction group (N-NSTEMI group, n = 232) and non-"N"-wave NSTEMI group (non N-NSTEMI group, n = 320). The basic data and the incidence of MACE during hospitalization and 12 months were analyzed.Results: In STEMI and N-NSTEMI groups, AST, CK, CK-MB, TnI, and stenosis severity were significantly higher than non N-NSTEMI (P < .05). The lesions in the N-NSTEMI and STEMI groups were more often located proximal LCX before giving rise to OM1 of LCX (P < .05), however, the non N-NSTEMI group was often located distal LCX after giving rise to OM1 and the OM1 (P < .05). The incidence rates of all MACEs, allcause death, ST, TVR, and rUAP were similar in N-NSTEMI and STEMI groups, which were greater than non N-NSTEMI (P < .05). Both N-NSTEMI and STEMI are independent risk factors for MACE (P < .05). Conclusion:The basic data and the incidence of major adverse cardiac event were similar in N-NSTEMI and STEMI patients, N-NSTEMI has a risk equivalent to acute STEMI. K E Y W O R D S acute non-ST-elevated myocardial infarction, acute ST-elevated myocardial infarction, delayed activation wave, left circumflex

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Fragmented QRS as a Marker of Myocardial Fibrosis in Hypertension: a Systematic Review

Eyuboglu¹

2019

Curr Hypertens Rep

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Association of fragmented QRS complexes on ECG with left ventricular diastolic function in hypertensive patients

Abstract: The presence of fQRS complexes on ECG predicts more severe diastolic dysfunction in patients with hypertension.

Cited by 6 publications

References 10 publications

Presence of fragmented QRS is associated with increased epicardial adipose tissue thickness in hypertensive patients

Presence of fragmented QRS is associated with increased epicardial adipose tissue thickness in hypertensive patients

Non‐ST‐elevated myocardial infarction with “N” wave on electrocardiogram and culprit vessel in left circumflex has a risk equivalent to ST‐elevated myocardial infarction

Fragmented QRS as a Marker of Myocardial Fibrosis in Hypertension: a Systematic Review

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