Muzaffer Kahyaoğlu1, Çetin Geçmen2, Mehmet Çelik2, Yusuf Yılmaz3, Emrah Bayam2, Ender Özgün Çakmak2, Özkan Candan4, İbrahim Akın İzgi5, Cevat Kırma2

1Gaziantep Abdulkadir Yüksel Devlet Hastanesi, Kardiyoloji, Gaziantep, Turkey
2Kartal Koşuyolu Yüksek İhtisas Eğitim Ve Araştirma Hastanesi, Kardiyoloji, İstanbul, Turkey
3Göztepe Eğitim Ve Araştırma Hastanesi, Kardiyoloji, İstanbul, Turkey
4Uşak Üniversitesi Tıp Fakültesi, Kardiyoloji, Uşak, Turkey
5Abant İzzet Baysal Üniversitesi, Kardiyoloji, Bolu, Turkey

Keywords: fragmented qrs, hypertension, left ventricular dysfunction, speckle tracking echocardiography

Abstract

Objectives: 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 ECG, 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.