Fragmented QRS in inferior leads is associated with non-alcholic fatty liver disease, body-mass index, and interventricular septum thickness in young men

Sarıkaya, Remzi; Şengül, Cihan; Kümet, Ömer; İmre, Gürkan; Akbulut, Tayyar; Oğuz, Mustafa

doi:10.5152/anatoljcardiol.2021.433

Cited by 4 publications

(1 citation statement)

References 32 publications

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“…This relationship has been noted in the previous study. (21) Almost all of the previous publications investigated the diagnostic performance of f-QRS only in the context of ischemic scars (e.g., patients with coronary artery disease and myocardial infarction). Our study explored the performance of f-QRS in both ischemic and non-ischemic scars.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging

Viriyanukulvong,

Theerasuwipakorn,

Wongcharoen

et al. 2024

Preprint

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Background: Fragmented QRS complex (f-QRS) on a 12-lead electrocardiogram (EKG) with a 0.15-100 Hz low-pass filter correlates with ischemic myocardial scars. While cardiac magnetic resonance (CMR) imaging enhances scar assessment, f-QRS diagnostic values for non-ischemic scars and routine 0.15-40 Hz filter EKGs are unknown. This study evaluates f-QRS (from EKGs with 0.15-40 and 0.15-100 Hz filters) in detecting myocardial scars (ischemic and non-ischemic) using 3.0 Tesla CMR. Methods: This cross-sectional study included patients undergoing 3.0 Tesla CMR from May 2020 to May 2023. Same-day 12-lead EKGs with 0.15-40 and 0.15-100 Hz filters were analyzed for f-QRS presence. Leads were categorized (anterior: V1-V4; lateral: I, aVL, V5-V6; inferior: II, III, aVF). f-QRS was defined as R? wave or notching in S wave nadir in 2 contiguous leads. Primary outcome: f-QRS diagnostic performance for myocardial scar detection in corresponding left ventricle (LV) segments. Secondary outcomes: Comparison of f-QRS in detecting ischemic/non-ischemic scars, between filter types, and in consecutive/solitary leads. Results: 1,692 participants (median age 67; 52.5% male) were included. Myocardial scars were found in 49%. Participants with f-QRS had a higher prevalence of male sex, CAD history, and scars. Median LVEF was lower in the f-QRS group. Sensitivity, specificity, PPV, NPV, and AUC of f-QRS (0.15-100 Hz filter) for myocardial scar detection varied across LV segments. Higher sensitivity, PPV, and LR+ were observed for non-ischemic scars with f-QRS. f-QRS from 0.15-100 Hz showed higher sensitivity but lower specificity, PPV, and LR+ across LV segments. Solitary lead f-QRS exhibited higher sensitivity but lower specificity, PPV, and LR+. Conclusion: 12-lead EKGs with 0.15-40 and 0.15-100 Hz low-pass filters show high specificity and negative predictive value for diagnosing myocardial scars corresponding to LV segments.

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Section: Discussionmentioning

confidence: 99%

Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging

Viriyanukulvong,

Theerasuwipakorn,

Wongcharoen

et al. 2024

Preprint

View full text Add to dashboard Cite

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Electrocardiographic abnormalities in patients with metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis

Dimala,

Nso,

Wasserlauf

et al. 2024

Current Problems in Cardiology

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Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging

Viriyanukulvong,

Theerasuwipakorn,

Wongcharoen

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Fragmented QRS complex (f-QRS) on a 12-lead electrocardiogram (EKG) with a 0.15–100 or 150 Hz low-pass filter is known to be related to ischemic myocardial scars. Cardiac magnetic resonance (CMR) imaging enhances tissue characterization capability resulting in a better myocardial scar assessment over other noninvasive imaging modalities. However, the diagnostic values of f-QRS on non-ischemic scars and f-QRS from EKG with a 015–40 Hz low-pass filter (routine filter in clinical practice) are unknown. This study aims to evaluate the diagnostic performance of f-QRS (from EKG with 0.15-40 and 0.15–100 Hz low-pass filters) for detecting any myocardial scars (both ischemic and non-ischemic) assessed by 3.0 Tesla CMR. Methods This cross-sectional study included patients who underwent a 3.0 Tesla CMR scan from May 2020 to May 2023. A 12-lead EKG with 0.15-40 and 0.15–100 Hz low-pass filters, performed on the same day of the CMR scan, was assessed for the presence of f-QRS. The ECG leads were divided into 3 categories (e.g., anterior leads V1-V4; lateral leads I, aVL, V5-V6; and inferior leads II, III, aVF). The f-QRS was defined as the presence of R’ wave or notching in the nadir of the S wave in 2 contiguous leads. The primary outcome was the diagnostic performance of f-QRS from EKG in myocardial scar detection in the corresponding left ventricle (LV) segments. The secondary outcomes were to compare the diagnostic performance of f-QRS in detecting ischemic scars and non-ischemic scars, the diagnostic performance between f-QRS diagnosed from 0.15-40 and 0.15–100 Hz low-pass filters, and the diagnostic performance of f-QRS presented in 2 consecutive leads and f-QRS presented in solitary lead. Results The study involved 1,692 participants with a median age of 67 (IQR: 59–85) years old and 52.5% males. Myocardial scars were found in 826 (49%) participants. Male, history of CAD, and myocardial scars were significantly more frequent in the participants with f-QRS (59.4% vs 46.0%, 26.4% vs 20.6%, and 48.9% vs 37.3%, respectively), while median LVEF was lower (61%, IQR 47, 66 vs 62%, IQR 55, 68; p < 0.001). The sensitivity, specificity, positive predictive value, negative predictive value, and AUC of f-QRS from EKG with 0.15–100 Hz low-pass filter for detecting myocardial scars were 25.6%, 88.7%, 45.1%, 76.8%, and 0.57 for anterior segments; 22.1%, 91.5%, 36.8%, 84.1%, and 0.57 for lateral segments; and 42.9%, 63.4%, 36.9, 68.9%, and 0.53 for inferior segments. The sensitivity, PPV, and positive likelihood ratio (LR+) of f-QRS were higher for detecting non-ischemic scars while specificity, NPV, negative likelihood ratio (LR-) and AUC were not significantly different. The f-QRS from 0.15–100 Hz showed a higher sensitivity but lower specificity, PPV, and LR + for all LV segments. The f-QRS presented in the solitary lead showed a higher sensitivity with a lower specificity, PPV, and LR+. Conclusion This study demonstrates a high specificity and negative predictive value of f-QRS from a 12-lead EKG with 0.15-40 and 0.15–100 Hz low-pass filters in diagnosing myocardial scars when correlated to the corresponding LV segments.

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Fragmented QRS in inferior leads is associated with non-alcholic fatty liver disease, body-mass index, and interventricular septum thickness in young men

Cited by 4 publications

References 32 publications

Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging

Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging

Electrocardiographic abnormalities in patients with metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis

Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging

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