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

Eyuboglu, Mehmet

doi:10.1007/s11906-019-0982-3

Cited by 19 publications

(13 citation statements)

References 39 publications

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“…Previous studies have reported that fQRS may be a sign of chronic and continuous pressure overload, especially due to increased systolic blood pressure that leads to pathological fibrosis in the presence or even absence of left ventricular hypertrophy. Additionally, increased interventricular septal thickness and left atrial diameter in FMS patients may also be related to the presence of fQRS in accordance with previous studies [38,39].…”

Section: Discussionsupporting

confidence: 91%

Subclinical cardiac structural and electrical abnormalities in fibromyalgia syndrome

et al. 2020

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Background/aim: In the literature, there is a paucity of data about the effects of fibromyalgia syndrome (FMS) on myocardial function and electrophysiological properties of atrium and ventricles. In this study, we investigated cardiac functions and noninvasive predictors of arrhythmias in patients with FMS. Materials and methods: The study included 43 female patients diagnosed with FMS and 30 age-and sex-matched healthy subjects. The presence of fragmented QRS (fQRS) morphology, P dispersion, QT dispersion, inter-and intraatrial electromechanical delay was evaluated in the groups with 12-lead ECG and standard and tissue Doppler echocardiography. Results: Among electrocardiographic parameters, P dispersion, QT dispersion, and the ratio of presence of fQRS morphology were found to be significantly higher in the study group as compared to the control group. In lateral and septal, the ratio of the early transmitral flow velocity to the early diastolic tissue velocity (E/Em) was significantly higher in the study group. Additionally, intra-and interatrial electromechanical delay was found significantly prolonged in the study group. Conclusion: FMS is found to be associated with significant cardiac electrical alterations that may indicate the increased risk of atrial and ventricular arrhythmias in this group of patients.

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Section: Discussionsupporting

confidence: 91%

Subclinical cardiac structural and electrical abnormalities in fibromyalgia syndrome

et al. 2020

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“…Hypertension is the most prevalent MetS component in the general Japanese population. A previous report showed a high prevalence of fQRS in subjects with hypertension [33]. In the current study, the contribution of hypertension on fQRS was not signi cant.…”

Section: Discussioncontrasting

confidence: 64%

High prevalence of fragmented QRS on electrocardiography in Japanese subjects with diabetes irrespective of metabolic syndrome

Yagi

Nagata

Yamagami

et al. 2020

Preprint

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BackgroundFragmented QRS (fQRS) on electrocardiography is a marker of myocardial fibrosis and myocardial scar formation. fQRS has been reported as a reliable predictor of adverse cardiac events in several populations. We investigated the relationship of fQRS with diabetes mellitus (DM) and metabolic syndrome (MetS) in Japanese patients.Material and methodsOur study enrolled a total of 702 subjects (435 without DM and 267 with type 2 DM) who had a routine health checkup at the Hokuriku Health Service Association (Toyama, Japan) in October 2014. Based on MetS and DM status, participants were categorized into one of the following four groups: DM+ MetS + (157 subjects); DM+ MetS - (110 subjects); DM- MetS + (82 subjects); and DM- MetS- (353 subjects). fQRS was assessed using the results of electrocardiography.ResultsThe prevalence of fQRS was statistically higher in patients with DM+MetS+ (36%) and DM+MetS- (36%), than those with DM-MetS+ (18%) or DM-MetS- (9%) (p < 0.001). Significant differences were observed between the fQRS(+) and fQRS(-) groups for age, gender, waist circumference (WC), heart rate, hypertension, HbA1c, TC, MetS, and DM. The area under the receiver-operating curve for traditional risk factors and DM was 0.72 (p=0.0021, 95% confidence interval [CI]: 0.68-0.77), and for traditional risk factors and MetS it was 0.69 (p=0.1478, 95% CI: 0.64-0.73). Patients with DM had more than three-fold higher likelihood of showing fQRS (odds ratio, 3.41; 95% CI, 2.25-5.22; p<0.0001) compared to the reference group without DM, after adjusting for age, gender, dyslipidemia, hypertension, and WC.ConclusionfQRS was observed more frequently in DM than in MetS and control subjects. DM was the most significant determinant for fQRS among MetS and other traditional metabolic risk factors in the general Japanese population.

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“…Fragmented QRS complex is a significant and independent predictor of cardiovascular arrhythmia [110][111][112][113]. Fragmented QRS complex is frequently seen in patients with LVH, and it was reported to be associated with ventricular arrhythmia [114][115][116].…”

Section: Fragmented Qrs Complexmentioning

confidence: 99%

Missing Link Between Molecular Aspects of Ventricular Arrhythmias and QRS Complex Morphology in Left Ventricular Hypertrophy

Bachárová

2019

IJMS

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The aim of this opinion paper is to point out the knowledge gap between evidence on the molecular level and clinical diagnostic possibilities in left ventricular hypertrophy (LVH) regarding the prediction of ventricular arrhythmias and monitoring the effect of therapy. LVH is defined as an increase in left ventricular size and is associated with increased occurrence of ventricular arrhythmia. Hypertrophic rebuilding of myocardium comprises interrelated processes on molecular, subcellular, cellular, tissue, and organ levels affecting electrogenesis, creating a substrate for triggering and maintaining arrhythmias. The knowledge of these processes serves as a basis for developing targeted therapy to prevent and treat arrhythmias. In the clinical practice, the method for recording electrical phenomena of the heart is electrocardiography. The recognized clinical electrocardiogram (ECG) predictors of ventricular arrhythmias are related to alterations in electrical impulse propagation, such as QRS complex duration, QT interval, early repolarization, late potentials, and fragmented QRS, and they are not specific for LVH. However, the simulation studies have shown that the QRS complex patterns documented in patients with LVH are also conditioned remarkably by the alterations in impulse propagation. These QRS complex patterns in LVH could be potentially recognized for predicting ventricular arrhythmia and for monitoring the effect of therapy.

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

Cited by 19 publications

References 39 publications

Subclinical cardiac structural and electrical abnormalities in fibromyalgia syndrome

Subclinical cardiac structural and electrical abnormalities in fibromyalgia syndrome

High prevalence of fragmented QRS on electrocardiography in Japanese subjects with diabetes irrespective of metabolic syndrome

Missing Link Between Molecular Aspects of Ventricular Arrhythmias and QRS Complex Morphology in Left Ventricular Hypertrophy

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