Fragmented QRS May Be Associated with Subclinical Left Ventricular Dysfunction in Patients with Hypertension
Muzaffer Kahyaoğlu1
, Çetin Geçmen2, Mehmet Çelik2, Yusuf Yılmaz3, Emrah Bayam2, Ender Özgün Çakmak2, Özkan Candan4, İbrahim Akın İzgi5, Cevat Kırma2
1Department of Cardiology, Abdulkadir Yuksel State Hospital, Gaziantep, Turkey
2Department of Cardiology, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
3Department of Cardiology, Goztepe Training and Research Hospital, Istanbul, Turkey
4Department of Cardiology, Faculty of Medicine, University of Usak, Usak, Turkey
5Department of Cardiology, Faculty of Medicine, University of Abant Izzet Baysal, Bolu, Turkey
Keywords: Fragmented QRS; hypertension; left ventricular dysfunction; speckle tracking echocardiography.
Abstract
Introduction: In hypertensive patients, the early detection of subclinical left ventricular dysfunction could prevent or delay patients from heart failure by aggressive risk factor control and rigorous medical management. Fragmented QRS (fQRS) is a marker of myocardial fibrosis, and myocardial fibrosis causes left ventricular dysfunction in hypertensive patients. In this study, we aimed to assess the association between the presence of fQRS and LV function at hypertensive patients using the speckle tracking echocardiography method.
Patients and Methods: The study included a total of 95 hypertensive patients. Detailed anamnesis, physical examination, laboratory tests, 12-lead electrocardiography, and conventional echocardiography were administered to all patients. The participating patients were divided into two groups as fQRS (+) (n= 33) and fQRS (-) (n= 62).
Results: Compared to the fQRS (-) group, the fQRS (+) group had older age, the average duration of hypertension was longer, and had a higher hemoglobin level. In the fQRS (+) group, interventricular septum thickness, posterior wall thickness, left ventricular mass index, relative wall thickness, deceleration time, and E/Em were significantly higher while left ventricular global longitudinal strain values were lower compared to fQRS (-) group. In the multiple linear regression analysis, fQRS and duration of hypertension were identified as independent predictors of LV-GLS.
Conclusion: In this study, we demonstrated that subclinical left ventricular dysfunction developing secondary to myocardial fibrosis could be predicted by fQRS, a simple marker in 12-lead electrocardiography.
The approval for this study was obtained from Kartal Koşuyolu High Speciality Training and Research Hospital Ethics Committee (Decision no: 2021/1/435, Date: 12.01.2021).
Informed consent was obtained.
Externally peer-reviewed.
Concept/Design - MK, ÇG; Analysis/Interpretation - MK, ÖC; Data Collection - MÇ, YY; Writing - MK, EB; Critical Revision - İİ, CK; Statistical Analysis - MK, ÇG; Overall Responsibility - MK, ÇG; Final Approval - All of authors.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.