Lütfü Bekar1, Macit Kalçık2, Hakan Kilci3, Oğuzhan Çelik4, Mucahit Yetim1, Tolga Doğan1, Orhan Önalan5. 1. Department of Cardiology, Hitit University, Faculty of Medicine, Çorum, Turkey. 2. Department of Cardiology, Hitit University, Faculty of Medicine, Çorum, Turkey. Electronic address: macitkalcik@yahoo.com. 3. Department of Cardiology, Şişli Hamidiye Eftal Training and Research Hospital, İstanbul, Turkey. 4. Department of Cardiology, Muğla Sıtkı Koçman Training and Research Hospital, Muğla, Turkey. 5. Department of Cardiology, Karabuk University Training and Research Hospital, Karabuk, Turkey.
Abstract
BACKGROUND: Ventricular arrhythmias (VAs) are frequent in hypertensive patients. Myocardial fibrosis is one of the components of left ventricular hypertrophy secondary to hypertension. Fragmented QRS (fQRS) on electrocardiography (ECG) has been shown to be a marker of myocardial fibrosis. In this study, we aimed to investigate the association between fQRS and complex VAs in patients with essential hypertension. METHODS: Two hundreds consecutive patients who were diagnosed with hypertension were included in the study. The control group consisted of 153 age and sex matched healthy individuals. ECG and transthoracic echocardiography were performed to all patients. fQRS was defined as additional R' wave or notching/splitting of S wave in two contiguous ECG leads. All patients underwent 24-hour Holter monitoring and VAs were classified using Lown's scoring system. Lown class ≥3 VAs were considered as complex VAs. RESULTS: There was no significant difference with respect to age (52 ± 8 vs 52 ± 6 years, p = 0.836) and gender distribution (female: 64% vs 63%, p = 0.907) between the groups. As compared to the healthy individuals, prevalence of fQRS (67% vs 9.2%, p < 0.001) and complex VAs (19% vs 0%, p < 0.001) were significantly higher in patients with hypertension. Furthermore, complex VAs (25.4% vs 6.1%, p = 0.001) were significantly higher in hypertensive patients with fQRS. In multiple logistic regression analysis, left ventricular ejection fraction (OR: 1.11, 95%CI: 1.025 to 1.183; p = 0.006), left ventricular mass index (OR: 1.04, 95%CI: 1.021 to 1.107; p = 0.001) and presence of fQRS (OR: 5.605, 95%CI: 1.427 to 22.019; p = 0.014) were independent predictors for complex VAs. CONCLUSION: The presence of fQRS may be associated with complex VAs in patients with essential hypertension. Therefore, fQRS may be used in risk stratification of complex VAs and sudden cardiac death especially in hypertensive patients with left ventricular hypertrophy.
BACKGROUND:Ventricular arrhythmias (VAs) are frequent in hypertensivepatients. Myocardial fibrosis is one of the components of left ventricular hypertrophy secondary to hypertension. Fragmented QRS (fQRS) on electrocardiography (ECG) has been shown to be a marker of myocardial fibrosis. In this study, we aimed to investigate the association between fQRS and complex VAs in patients with essential hypertension. METHODS: Two hundreds consecutive patients who were diagnosed with hypertension were included in the study. The control group consisted of 153 age and sex matched healthy individuals. ECG and transthoracic echocardiography were performed to all patients. fQRS was defined as additional R' wave or notching/splitting of S wave in two contiguous ECG leads. All patients underwent 24-hour Holter monitoring and VAs were classified using Lown's scoring system. Lown class ≥3 VAs were considered as complex VAs. RESULTS: There was no significant difference with respect to age (52 ± 8 vs 52 ± 6 years, p = 0.836) and gender distribution (female: 64% vs 63%, p = 0.907) between the groups. As compared to the healthy individuals, prevalence of fQRS (67% vs 9.2%, p < 0.001) and complex VAs (19% vs 0%, p < 0.001) were significantly higher in patients with hypertension. Furthermore, complex VAs (25.4% vs 6.1%, p = 0.001) were significantly higher in hypertensivepatients with fQRS. In multiple logistic regression analysis, left ventricular ejection fraction (OR: 1.11, 95%CI: 1.025 to 1.183; p = 0.006), left ventricular mass index (OR: 1.04, 95%CI: 1.021 to 1.107; p = 0.001) and presence of fQRS (OR: 5.605, 95%CI: 1.427 to 22.019; p = 0.014) were independent predictors for complex VAs. CONCLUSION: The presence of fQRS may be associated with complex VAs in patients with essential hypertension. Therefore, fQRS may be used in risk stratification of complex VAs and sudden cardiac death especially in hypertensivepatients with left ventricular hypertrophy.
Authors: Kathleen Bird; Gabriel Chan; Huiqi Lu; Heloise Greeff; John Allen; Derek Abbott; Carlo Menon; Nigel H Lovell; Newton Howard; Wee-Shian Chan; Richard Ribon Fletcher; Aymen Alian; Rabab Ward; Mohamed Elgendi Journal: Front Med (Lausanne) Date: 2020-12-04
Authors: Mehmet Altunova; Hamdi Püşüroğlu; Muammer Karakayalı; Ahmet Anıl Şahin; Ali Rıza Demir; Emre Yılmaz; Ahmet Yaşar Çizgici; Mehmet Ertürk Journal: Anatol J Cardiol Date: 2022-06 Impact factor: 1.475