Relationship between fragmented QRS complexes and left ventricular systolic and diastolic functions

Çanğa, Aytun; Kocaman, Sinan Altan; Durakoğlugil, Murtaza Emre; Çetin, Mustafa; Kırış, Tuncay; Erden, Murat

doi:10.1007/s00059-012-3739-1

Cited by 15 publications

(15 citation statements)

References 27 publications

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“…Therefore, greater localized fixed defects on SPECT are associated with fQRS, which could possibly improve the detection of previous silent infarcts. Furthermore, we found a reverse relation between ejection fraction and fQRS (OR=0.91, 95% CI=0.859-0.96; p=0.002), which is concordant with other studies (36, 37). However, some of the studies mentioned, have been conducted in patients with a history of MI, whereas our results have been obtained from patients without a history of MI.…”

Section: Discussionsupporting

confidence: 92%

Significance of a fragmented QRS complex in patients with chronic total occlusion of coronary artery without prior myocardial infarction

Bonakdar¹,

Moladoust²,

Kheirkhah³

et al. 2015

Anatol J Cardiol

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Objective:Fragmented QRS (fQRS) complexes that have numerous RSR´ patterns represent alteration of ventricular depolarization. We evaluated the relationship between fQRS and poor coronary collateral circulation and the diagnostic ability of fQRS for myocardial scar detection in patients with chronic total occlusion (CTO) without a history of myocardial infarction.Methods:The study population consisted of patients undergoing coronary angiography with a suspicion of CAD. Seventy-nine patients with one totally occluded major coronary artery were enrolled. Exclusion criteria were history of MI; recent acute coronary syndrome; pathologic Q wave on 12-lead ECG; cardiomyopathy or severe valvular disease; coronary artery bypass surgery or percutaneous coronary angioplasty. Collateral circulation was scored on the basis of Rentrop's classification. All patients were assessed by myocardial perfusion SPECT. Fragmented QRS was characterized as existence of an R´ or R wave or S wave notch in two adjacent leads related to the location of a major coronary artery region. Single and multiple logistic regression analyses were completed in the forward method.Results:Forty-nine patients had poor and 30 had well-developed collateral circulation. Fragmented QRS complexes were significantly higher in the poor collateral group (81% vs. 20%, p<0.001). Sensitivity, specificity, and the positive and negative predictive values of fQRS for myocardial scar identification were 89.4%, 87.5%, and 91.3% and 84.8%, respectively. The summed stress score and the summed rest score on SPECT were significantly higher in the poor collateral group than in the well-developed group (p<0.001) as well as in the fQRS group than the non-fQRS group (p<0.001). Logistic regression analysis revealed that the presence of fQRS was significantly and independently associated with poor collateral circulation and myocardial scar in patients with CTO.Conclusion:Fragmented QRS is independently related to poor coronary collateral circulation in patients with CTO without prior myocardial infarction. Notably, it can be a good predictor of myocardial scar rather than merely ischemia, with high diagnostic accuracy.

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Section: Discussionsupporting

confidence: 92%

Significance of a fragmented QRS complex in patients with chronic total occlusion of coronary artery without prior myocardial infarction

Bonakdar¹,

Moladoust²,

Kheirkhah³

et al. 2015

Anatol J Cardiol

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“…In their studies, Das and colleagues concluded that fQRS might be a sensitive marker for MI and that its negative predictive value is higher when compared with that of Q wave. They also reported that it might be an indicator of arrhythmia in coronary artery patients and nonischemic dilated cardiomyopathy patients [12][13][14][15][16][17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…It is clear that fibroses and scars that occur in myocardial tissue because of the infarct or ischemia will cause abnormalities in motion as well as mural thickening [19].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of fragmented QRS and myocardial perfusion-gated SPECT findings

Özdemir

Tan

Çölkesen

et al. 2013

Nuclear Medicine Communications

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“…In various conditions, fQRS has been regarded as a marker of inhomogeneous activation of the ventricles related with myocardial scar, and has been linked to the risk for ventricular tachyarrhythmias and sudden death1617). Recently, Canpolat et al1617) reported that electrocardiogram leads with fQRS in arrhythmogenic right ventricular dysplasia was higher in patients with arrhythmic events.…”

Section: Discussionmentioning

confidence: 99%

The evolution of electrocardiographic changes in patients with Duchenne muscular dystrophies

et al. 2017

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PurposeMyocardial dysfunction and dysrhythmias are inevitable consequences of Duchenne muscular dystrophy. We aimed to evaluate specific trends of electrocardiographic changes that reflect the progress of cardiomyopathy in patients with Duchenne muscular dystrophy.MethodsFifty electrocardiograms (ECGs) of 30 patients (ages 1 to 27 years) who had not been prescribed medications for heart failure treatment at the time of examination were retrospectively analyzed and compared with 116 ECGs of age-matched healthy 116 controls. Heart rate, leads with fragmented QRS (fQRS), corrected QT, Tpeak-to-Tend, and Tpeak-to-Tend/QT were analyzed.ResultsThe patients with Duchenne muscular dystrophy failed to show a normal age-related decline in heart rate but showed an increasing trend in the prevalence of fQRS, corrected QT, corrected Tpeak-to-Tend, and Tpeak-to-Tend/QT over time. In the ≤10-year-old patient group, a significant difference was found only in the prevalence of fQRS between the patients and the controls. The prevalence of fQRS, heart rate, Tpeak-to-Tend/QT, and corrected Tpeak-to-Tend demonstrated significant differences between the patients and the controls in the middle age group (11 to 15 years old). All the indexes were statistically significantly different in the ≥16-year-old patient group.ConclusionThe prevalence of lead with fQRS representing regional wall motion abnormalities was higher in the young patients than in the young healthy controls, and this might be one of the first signs of myocardial change in the patients. Markers of depolarization and repolarization abnormalities were gradually prominent in the patients aged >10 years. Further studies are needed to confirm these findings.

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Relationship between fragmented QRS complexes and left ventricular systolic and diastolic functions

Abstract: We found that fQRS is related to left ventricular systolic dysfunction and diastolic dysfunction. fQRS, which may be the result of myocardial ischemia or scar on myocardial electrical parameters at the cellular level, may represent inadequate systolic and diastolic functions.

Cited by 15 publications

References 27 publications

Significance of a fragmented QRS complex in patients with chronic total occlusion of coronary artery without prior myocardial infarction

Significance of a fragmented QRS complex in patients with chronic total occlusion of coronary artery without prior myocardial infarction

Comparison of fragmented QRS and myocardial perfusion-gated SPECT findings

The evolution of electrocardiographic changes in patients with Duchenne muscular dystrophies

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