The role of fQRS in coronary artery disease

Xu, Yuan; Qiu, Zhiqiang; Bao, Huihui; Gao, Shan; Cheng, Xiaoshu

doi:10.1007/s00059-014-4155-5

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…Recently, fQRS has been reported more in its prognostic effects of poor clinical outcomes in several cardiac conditions (Bonakdar et al, 2016;Das et al, 2010;Rattanawong et al, 2017;Xu et al, 2015). Suggested mechanism of fQRS is explained by electrical dyssynchrony of interventricular conduction (Sinha et al, 2016), which could result from a myocardial scar.…”

Section: Discussionmentioning

confidence: 99%

“…Fragmented QRS (fQRS), which reflects myocardial scarring, has been found to be associated with poor prognostic outcome in several cardiac conditions, including coronary artery disease (Xu et al, 2015), non-ischemic cardiomyopathy (Das et al, 2010), Brugada syndrome (Rattanawong et al, 2017), chronic total occlusion (Bonakdar et al, 2016), and hypertrophic cardiomyopathy (Rattanawong et al, 2018). Recent studies have demonstrated poor prognostic outcome in HFrEF patients whose baseline ECG was positive for fQRS.…”

Section: Introductionmentioning

confidence: 99%

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Baseline fragmented QRS is associated with increased all‐cause mortality in heart failure with reduced ejection fraction: A systematic review and meta‐analysis

Kanitsoraphan

Rattanawong

Mekraksakit

et al. 2018

Noninvasive Electrocardiol

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Background: Recent studies suggested that fragmented (fQRS) is associated with poor clinical outcomes in heart failure with reduced ejection fraction (HFrEF) patients. However, no systematic review or meta-analysis has been done. We conducted a systematic review and meta-analysis to assess the association between baseline fQRS and all-cause mortality in HFrEF. Methods:We comprehensively reviewed the databases of MEDLINE and EMBASE from inception to February 2018. Published studies of HFrEF that reported fQRS and outcome of all-cause mortality and major arrhythmic event (sudden cardiac death, sudden cardiac arrest, ventricular fibrillation, or sustained ventricular tachycardia) were included. Data were integrated using the random-effects, generic inverse-variance method of DerSimonian and Laird.Results: Ten studies from 2010 to 2017 were included. Baseline fQRS was associated with increased all-cause mortality (risk ratio [RR] 1.63, 95% confidence interval [CI] 1.22-2.19, p < 0.0001, I 2 = 73%) as well as major arrhythmic events (RR = 1.74, 95% CI 1.09-2.80, I 2 = 89%). Baseline fQRS increased all-cause mortality in both Asian and Caucasian cohorts (RR = 2.17 with 95% CI 1.33-3.55 and RR = 1.45 with 95% CI 1.05-1.99, respectively) as well as increased major arrhythmic events in Asian cohort (RR = 1.50, 95% CI 1.05-2.13). Baseline fQRS also increased all-cause mortality in patients who had not received implantable cardioverter-defibrillator, significantly more than in patients who had received implantable cardioverter-defibrillator

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Baseline fragmented QRS is associated with increased all‐cause mortality in heart failure with reduced ejection fraction: A systematic review and meta‐analysis

Kanitsoraphan

Rattanawong

Mekraksakit

et al. 2018

Noninvasive Electrocardiol

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“…This prevalence is considerably higher than in the general population-where it is just over 5%. 12,27,28 The presence of QRS fragmentation was associated with larger MIs as measured by total serum creatine kinase levels (1438.0 vs. 1160.0 U/L, p = .039) and with slightly lower left ventricular ejection fraction (52% vs. 54%, p = .011). In addition, the QRS complexes of patients with fragmentation were significantly wider than those of patients without QRS fragmentation (90 vs. 85 ms, p < .001).…”

Section: Discussionmentioning

confidence: 96%

“…Recently, fragmentations of the QRS complex (fQRS) in resting 12-lead electrocardiograms (ECG) have been discussed as a potential simple risk predictor in cardiac patients. [12][13][14][15][16][17][18] Narrow QRS complexes with an unremarkable morphology are found in patients with a normal electrical excitation propagation in the ventricles. If the electrical excitation propagation is impaired, for example, due to areas of myocardial fibrosis or scar, 13,19 cardiomyopathies, 20 channelopathies, 21,22 or systemic diseases with cardiac involvement such as sarcoidosis, 23 QRS morphology can be altered or fragmented.…”

Section: Introductionmentioning

confidence: 99%

QRS fragmentation does not predict mortality in survivors of acute myocardial infarction

Allescher,

Sinnecker,

von Goeldel

et al. 2024

Clinical Cardiology

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BackgroundDespite advances in coronary revascularization and in heart failure management, myocardial infarction survivors remain at substantially increased mortality risk. Precise risk assessment and risk‐adapted follow‐up care are crucial to improve their outcomes. Recently, the fragmented QRS complex, i.e. the presence of additional spikes within the QRS complexes on a 12‐lead electrocardiogram, has been discussed as a potential non‐invasive risk predictor in cardiac patients.HypothesisThe aim of this study was to evaluate the prognostic meaning of the fragmented QRS complex in myocardial infarction survivors.Methods609 patients with narrow QRS complexes <120 ms were included in a prospective cohort study while hospitalized for myocardial infarction and followed for 5 years.ResultsThe prevalence of the fragmented QRS complex in these patients amounted to 46.8% (285 patients). These patients had no increased hazard of all‐cause death (HR 0.84, 95%–CI 0.45–1.57, p = 0.582) with a mortality rate of 6.0% compared to 7.1% in patients without QRS fragmentations. Furthermore, the risks of cardiac death (HR 1.28, 95%–CI 0.49–3.31, p = 0.613) and of non‐cardiac death (HR 0.6, 95%–CI 0.26–1.43, p = 0.25) were not significantly different in patients with QRS fragmentations. However, patients with QRS fragmentations had increased serum creatine kinase concentrations (1438U/l vs. 1160U/l, p = 0.039) and reduced left ventricular ejection fractions (52% vs. 54%, p = 0.011).ConclusionsThe hypothesis that QRS fragmentation might be a prognostic parameter in survivors of myocardial infarction was not confirmed. But those with QRS fragmentation had larger myocardial infarctions, as measured by creatine kinase and left ventricular ejection fraction.

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“…По данным метаанализа, включившего 16 обсервационных исследований (3997 пациентов с ИБС), вероятность развития переднего инфаркта повышалась более чем в 2 раза при наличии fQRS (ОШ = 2,4; 95%-й ДИ: 1,1-5,5; p = 0,03). В свою очередь, частота развития крупных сердечно-сосудистых катастроф и смертность оказались значимо выше в группе с fQRS в сравнении с группой без fQRS (соответственно ОШ = 3,2; p < 0,00001 и ОШ = 2,2; p < 0,0001) [28].…”

Section: Fqrs -предиктор неблагоприятного течения ибсunclassified

QRS-Fragmentation: Perspectives for Use in Clinical Practice

et al. 2021

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The current article provides a detail review of foreign publications, discussing the opportunities and the benefits of evaluation of the QRS-fragmentation (fQRS) a new electrocardiographic (ECG) parameter in patients with coronary artery disease (CAD). Diagnostic criteria for narrow and wide QRS-complexes are defined. Main results of the comparative and correlation analysis, evaluating fQRS and electrocardiographic (pathologic Q-waves), echocardiographic (left ventricular ejection fraction), angiographic settings are described. There is a discussion of the prognostic role of fQRS in stable CAD as well as in patients presented with acute myocardial infarction. fQRS is an available ECG-marker of local myocardial fibrosis. It seems to be a useful negative predictor in individuals with CAD, indicating an increased risk of life-threatening ventricular arrhythmias and recurrent cardiac events. The presence of fragmented QRS-complexes is associated with an increased in-hospital and long term (overall as well as cardiovascular) mortality. Routine evaluation of fQRS in standard ECG leads does not require additional resources, and will contribute to an improvement in diagnostics and risk stratification of stable CAD as well as myocardial infarction. Assessment of fQRS can be included in noninvasive diagnostic algorithm concerning CAD.

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The role of fQRS in coronary artery disease

Abstract: Based on current evidence, fQRS was associated with increased MACE, mortality, Q waves, anterior-wall MI, and decreased LVEF in CAD. These findings show that fQRS is a reliable marker in CAD.

Cited by 9 publications

References 26 publications

Baseline fragmented QRS is associated with increased all‐cause mortality in heart failure with reduced ejection fraction: A systematic review and meta‐analysis

Baseline fragmented QRS is associated with increased all‐cause mortality in heart failure with reduced ejection fraction: A systematic review and meta‐analysis

QRS fragmentation does not predict mortality in survivors of acute myocardial infarction

QRS-Fragmentation: Perspectives for Use in Clinical Practice

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