Fragmented QRS complexes are associated with left ventricular systolic and diastolic dysfunctions in patients with metabolic syndrome

Oner, Ender; Ertürk, Mehmet; Birant, Ali; Kalkan, Ali Kemal; Uzun, Fatih; Avcı, Yalçın; Gürdoğan, Muhammet; Püşüroğlu, Hamdi; Yildirim, Aydın

doi:10.5603/cj.a2015.0045

Cited by 20 publications

(18 citation statements)

References 29 publications

(39 reference statements)

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“…3 In healthy smokers, coronary flow reserves are affected and the outcome of the variation in coronary circulation not meeting myocardial oxygen requirements causes diastolic function disorder. [16][17][18][19] In our study, this rate was 18.4%, which is higher than non-smokers healthy individuals. To identify myocardial fibrosis, histopathological evaluation, cardiac magnetic resonance imaging, and scintigraphy may be used; however, these methods are expensive and may be difficult to access.…”

Section: Discussioncontrasting

confidence: 49%

Association between fragmented QRS complexes and left ventricular dysfunction in healthy smokers

et al. 2018

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Objective Smoking is a known risk factor for cardiovascular diseases and may cause myocardial damage independently of coronary artery disease. Fragmented QRS (fQRS) is an important marker of myocardial fibrosis, while speckle‐tracking echocardiography is a method used to show subclinical left ventricle dysfunction. Methods Our study included 230 healthy individuals aged 18–40 years. The patients included were separated into two groups: those smokers (n = 130) and non‐smokers (n = 100). After that healthy smokers group were divided into two groups: those with fQRS (n = 24) and those without (n = 106). In both groups, the arithmetic mean of three images was used to obtain the left ventricle global longitudinal strain (LV‐GLS). The E/SRe ratio was also calculated and analyzed. Results There were significant differences between the smokers and non‐smokers in terms of, E/SRe (55.7 ± 17.9 vs 50.3 ± 14.8; P = 0.015), LV‐GLS (23.1 ± 1.9 vs 24.0 ± 1.7; P = 0.001), and fQRS (18.5% vs 6%; P = 0.005). As a result of subgroup analysis, pack‐year history was higher in the fQRS positive group (16.7 ± 3.7 vs 11.2 ± 3.7, P < 0.001). While a negative correlation was observed between pack‐year history and LV‐GLS (r = –0.678, P < 0.001), there was a positive correlation between pack‐year history and E/SRe (r = 0.730, P < 0.001). Conclusion In conclusion, our study demonstrated that fQRS is a parameter that can be used to determine left ventricle subclinical systolic and diastolic dysfunction in smokers, and that left ventricle dysfunction is related to the duration and intensity of smoking.

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Section: Discussioncontrasting

confidence: 49%

Association between fragmented QRS complexes and left ventricular dysfunction in healthy smokers

et al. 2018

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“…The fQRS has also been found to be associated with subtle myocardial dysfunction in several reports. Oner et al evaluated patients with metabolic syndrome and compared them with matched control individuals without metabolic syndrome. They observed that fQRS was more common among patients with metabolic syndrome compared to those without it (26.1% vs 14.6%, P = .041).…”

Section: Discussionmentioning

confidence: 99%

“…Based on a population‐based study in Finland, the rate of healthy individuals with fQRS was 18.3% (1518 of 8277 individuals without known cardiac diseases), and it has been found to be 14.6% among a healthy population in a case‐control study . In contrast, the prevalence of fQRS in other population is significantly greater than healthy population.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, the prevalence of fQRS in other population is significantly greater than healthy population. The prevalence of fQRS in patients with chronic kidney disease with preserved LVEF, metabolic syndrome, heart failure patients requiring resynchronization therapy, and diabetes mellitus was 60%, 26%, 41.5%, and 28%, respectively. In a former population‐based study, the fQRS in healthy middle‐aged individuals was frequent, but it did not affect the occurrence of cardiac death, arrhythmic death, and death from any causes during a mean of 30 years follow‐up .…”

Section: Discussionmentioning

confidence: 99%

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Fragmented QRS and subclinical left ventricular dysfunction in individuals with preserved ejection fraction: A speckle‐tracking echocardiographic study

Dehghani

Rostamzadeh

Abbasnezhad

et al. 2019

Journal of Arrhythmia

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Introduction Fragmented QRS (fQRS) complex on routine 12‐lead electrocardiogram (ECG) predicts adverse outcomes in patients with cardiovascular diseases. In addition, it has been found to be associated with subclinical myocardial dysfunction in chronic diseases. We sought to investigate the relationship between the presence of fQRS with the myocardial functions in individuals free from known systemic cardiovascular diseases. Methods In a case‐control study, we evaluated normal individuals from March 2017 to February 2018. All participants underwent a 2‐dimensional transthoracic echocardiographic examination using tissue Doppler imaging (TDI) and speckle‐tracking echocardiography. In addition, all participants were examined using a 12‐lead surface ECG, and patients with fQRS and a group of age‐ and sex‐matched controls without fQRS were enrolled in our study. Results The patients' mean age was 40.3 ± 10.7 and 35.4 ± 11.2 years in fQRS‐positive and fQRS‐negative groups, respectively (P = .110). Patients with fQRS had significantly lower values of apical left ventricular global longitudinal strain (LV GLS) in 2‐chamber (16.9 ± 2.5 vs. 20.5 ± 3.3, P < .001), 4‐chamber (16.9 ± 3.4 vs. 20.1 ± 3, P = .001), LAX views (17.7 ± 2.8 vs. 20.8 ± 3.5, P = .001), and averaged LV GLS (17 ± 2.6 vs. 20.4 ± 2.7, P < .001) values compared to patients without fQRS. In a multivariate analysis, averaged LV GLS and smoking history were independent predictors for positive fQRS. Conclusion The presence of fQRS on 12‐lead ECG in healthy population was associated with lower values of LV GLS compared to normal individuals without fQRS.

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“…It was also shown that EAT was independently associated with presence of fQRS. fQRS on ECG has been regarded as a marker of myocardial fibrosis or scarring in different diseases and independent predictor of cardiac events in patients with coronary artery disease (9)(10)(11) .…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Epicardial Adipose Tissue Thickness and Fragmented QRS

Akyüz¹,

Kul²,

Sayın³

et al. 2017

Kosuyolu Heart Journal

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Introduction: Fragmented QRS (fQRS) on a 12-lead electrocardiogram (ECG) has been demonstrated as a marker of myocardial fibrosis. The main purpose of present study was to investigate the association between epicardial adipose tissue (EAT) and fQRS.Patients and Methods: Study population consisted of 151 patients had fQRS detected on a routine 12-lead ECG and 114 controls without fQRS. EAT was assessed by measuring epicardial fat thickness with echocardiography. fQRS was defined by the presence of various RSR' patterns included an additional R wave (R), notching of the R wave, notching of the downstroke or upstroke of the S wave, or the presence of > 1 R in 2 contiguous leads corresponding to a major coronary artery territory.Results: Patients with fQRS had higher EAT values than those without fQRS (5.9 ± 2.7, 3.8 ± 2.3, p< 0.001). Univariate analyses demonstrated significant association between fQRS and EAT (p< 0.001), hypertension (p= 0.015). Binary logistic regression analysis revealed EAT (95% confidence interval [CI] 1.053-1.938, p= 0.022) and total cholesterol (95% CI: 1.001-1.030, p= 0.037) as independent determinants of fQRS. Conclusion:In the present study, we found higher amounts of EAT in subjects with fQRS. In addition, presence of fQRS was independently associated with EAT. Hastalar ve Yöntem:Çalışmaya kardiyoloji polikliniğimize müracaat edip rutin eloktrokardiyografik incelemede pQRS'si olan 151 hasta ve kontrol grubu olarak pQRS'si olmayan 114 hasta alındı. EYK ekokardiyografide hesaplandı. Parçalanmış QRS birbirini takip eden iki EKG derivasyonunda ilave R dalgası (R') veya R veya S dalgasında çentiklenme veya bölünme varlığı olarak alındı. Bulgular: pQRS olan hastalarda EYK değerleri daha yüksekti (5.9 ± 2.7, 3.8 ± 2.3, p< 0.001). Tek değişkenli analiz EYK ile pQRS (p< 0.001) ve hipertansiyon (p= 0.015) arasında anlamlı bir ilişki olduğunu göstermiştir. Binary lojistik regresyon analizi, EYK [%95 güven aralığı (GA) 1.053-1.938, p= 0.022] ve total kolesterolü (%95 GA: 1.00-1.030, p= 0.037) pQRS'nin bağımsız bir belirleyicisi olarak ortaya koydu.Sonuç: Bu çalışmada, pQRS'li hastalarda EYK'yi artmış olarak tespit ettik. Buna ek olarak EYK, pQRS'nin güçlü ve bağımsız bir belirteci olarak bulunmuştur.Anahtar Kelimeler: Parçalı QRS; epikardiyal yağ dokusu; miyokardiyal fibrozis

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Fragmented QRS complexes are associated with left ventricular systolic and diastolic dysfunctions in patients with metabolic syndrome

Cited by 20 publications

References 29 publications

Association between fragmented QRS complexes and left ventricular dysfunction in healthy smokers

Association between fragmented QRS complexes and left ventricular dysfunction in healthy smokers

Fragmented QRS and subclinical left ventricular dysfunction in individuals with preserved ejection fraction: A speckle‐tracking echocardiographic study

Relationship Between Epicardial Adipose Tissue Thickness and Fragmented QRS

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