Kosuyolu Heart J 2013;16(2)
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Kosuyolu Heart J 2013;16(2):93-98 - doi: 10.5578/kkd.4653
Hipertansif Hastalarda Fragmente QRS ve Sol Ventrikül Geometrisi

Fragmented QRS and Left Ventricular Geometry in Hypertensive Patients

Lütfü Bekar1, Savaş A. Çelebi1


1 Department of Cardiology, Tokat State Hospital, Tokat, Turkey

ABSTRACT

Introduction: Fragmented QRS is a depolarization abnormality detected with routin ECG recording. It is related with conduction defect which occurs after myocardial fibrosis. In the left ventricular hypertrophy, an excessive amount of collagen accumulates in the interstitium when the myocytes became hypertrophied, resulting in myocardial fibrosis. In this study, we aimed to investigate the relationship of fragmented QRS which was detected on ECG recordings of the hypertensive patients with the left ventricular geometry.

Patients and Methods: Essential hypertension patients referred to our hospital on outpatient bases were included in the study. 12-lead resting ECG was taken in all the patients. Left ventricular geometry defined using left ventricular mass index and relative wall thickness with transthorasic echocardiography.

Results: Sixy seven patients with fragmented QRS and 63 patients without fragmented QRS included the study. We found that patients in the group with fragmented QRS detected have a wider mean left atrium diameter, greater left ventricular mass and left ventricular mass index compared with the group without fragmented QRS. Concentric and eccentric hypertrophy were more common in fragmented QRS group, while normal geometry and concentric remodelling have greater rates in the normal group.

Conclusion: Left ventricular hypertrophy is observed more frequently in the patients with fragmented QRS than without fragmented QRS. This may be associated with the increased myocardial fibrosis in the left ventricular hypertrophy. Existence of fragmented QRS can be used for risk stratification in the hypertensive patients.

Key Words: Hypertension; arrhythmias, cardiac; endomyocardial fibrosis; electrocardiography.

Received: 22.12.2012 Accepted: 26.12.2012

Correspondence

Dr. LütfüBekar

Tokat Devlet Hastanesi Kardiyoloji Kliniği

Tokat-Türkiye

e-posta: lbb2006@gmail.com

Hipertansif Hastalarda Fragmente QRS ve Sol Ventrikül Geometrisi

Hipertansif Hastalarda Fragmente QRS ve Sol Ventrikül Geometrisi

Fragmented QRS and Left Ventricular Geometry in Hypertensive Patients

Lütfü Bekar1, Savaş A. Çelebi1


1 Tokat Devlet Hastanesi, Kardiyoloji Kliniği, Tokat, Türkiye

1 Department of Cardiology, Tokat State Hospital, Tokat, Turkey

ÖZET

Giriş: Fragmente QRS rutin EKG kayıtlarında saptanan bir depolarizasyon bozukluğudur. Miyokart fibrozisi sonrası gelişen ileti kusuruna bağlı geliştiği bilinmektedir. Sol ventrikül hipertrofisinde miyositler hipertrofi olurken interstisyumda abartılı bir kollajen birikimi olur, bu da miyokardiyal fibrozise neden olur. Bu çalışmada hipertansif hastaların rutin EKG kayıtlarında saptanan fragmente QRS'nin sol ventrikül geometrisi ile olan ilişkisini araştırmayı planladık.

Hastalar ve Yöntem: Çalışmamıza hastanemize ayaktan başvuran esansiyel hipertansiyon hastaları dahil edildi. Çalışmaya dahil edilen tüm hastalardan 12 derivasyonlu istirahat EKG'si çekildi. Transtorasik ekokardiyografiyle sol ventrikül kitle indeksi ve göreceli duvar kalınlığı kullanılarak sol ventrikül geometrisi belirlendi.

Bulgular: Çalışmamıza EKG kaydında fragmente QRS saptanan 67 hasta ile fragmente QRS saptanmayan 63 hasta alındı. Fragmente QRS saptanan grup olmayanla kıyaslandığında sol atriyum çapının daha geniş olduğu, sol ventrikül kitlesi ve sol ventrikül kitle indeksinin daha fazla olduğu saptandı. Fragmente QRS saptanan grupta konsantrik ve eksantrik hipertrofi daha fazla görülürken, saptanmayan grupta normal geometri ve konsantrik remodelling daha fazla idi.

Sonuç: Fragmente QRS'ye sahip hipertansif hastalarda sol ventrikül hipertrofisi olmayanlara göre daha sık izlenir. Bu durum sol ventrikül hipertrofisindeki artmış miyokardiyal fibrozis ile ilişkili olabilir. Fragmente QRS varlığı hipertansif hastalarda risk sınıflamasında kullanılabilir.

Anahtar Kelimeler: Hipertansiyon; aritmiler, kalp; endomiyokardiyal fibrozis; elektrokardiyografi.

Geliş Tarihi: 22.12.2012 Kabul Tarihi: 26.12.2012

ABSTRACT

Introduction: Fragmented QRS is a depolarization abnormality detected with routin ECG recording. It is related with conduction defect which occurs after myocardial fibrosis. In the left ventricular hypertrophy, an excessive amount of collagen accumulates in the interstitium when the myocytes became hypertrophied, resulting in myocardial fibrosis. In this study, we aimed to investigate the relationship of fragmented QRS which was detected on ECG recordings of the hypertensive patients with the left ventricular geometry.

Patients and Methods: Essential hypertension patients referred to our hospital on outpatient bases were included in the study. 12-lead resting ECG was taken in all the patients. Left ventricular geometry defined using left ventricular mass index and relative wall thickness with transthorasic echocardiography.

Results: Sixy seven patients with fragmented QRS and 63 patients without fragmented QRS included the study. We found that patients in the group with fragmented QRS detected have a wider mean left atrium diameter, greater left ventricular mass and left ventricular mass index compared with the group without fragmented QRS. Concentric and eccentric hypertrophy were more common in fragmented QRS group, while normal geometry and concentric remodelling have greater rates in the normal group.

Conclusion: Left ventricular hypertrophy is observed more frequently in the patients with fragmented QRS than without fragmented QRS. This may be associated with the increased myocardial fibrosis in the left ventricular hypertrophy. Existence of fragmented QRS can be used for risk stratification in the hypertensive patients.

Key Words: Hypertension; arrhythmias, cardiac; endomyocardial fibrosis; electrocardiography.

Received: 22.12.2012 Accepted: 26.12.2012

YazışmaAdresi/Correspondence

Dr. LütfüBekar

Tokat Devlet Hastanesi Kardiyoloji Kliniği

Tokat-Türkiye

e-posta: lbb2006@gmail.com

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