Kyohei Marume1,2, Teruo Noguchi1, Tsukasa Kamakura1, Emi Tateishi3, Yoshiaki Morita4, Hiroyuki Miura1, Yuriko Nakaoku5, Kunihiro Nishimura5, Naoaki Yamada6, Kenichi Tsujita2, Chisato Izumi1, Kengo Kusano1, Hisao Ogawa1, Satoshi Yasuda1. 1. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan. 2. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. 3. Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 4. Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan. 5. Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 6. Department of Radiology, Osaka Neurological Institute, Toyonaka, Osaka, Japan.
Abstract
AIMS: To evaluate the prognostic impact of fragmented QRS (fQRS) on idiopathic dilated cardiomyopathy (DCM). METHODS AND RESULTS: We conducted a prospective observational study of 290 consecutive patients with DCM (left ventricular ejection fraction ≤ 40%) and narrow QRS who underwent cardiac magnetic resonance. We defined fQRS as the presence of various RSR' patterns in ≥2 contiguous leads representing the anterior (V1-V5), inferior (II, III, and aVF), or lateral (I, aVL, and V6) myocardial segments. Multiple fQRS was defined as the presence of fQRS in ≥2 myocardial segments. Patients were divided into three groups: no fQRS, single fQRS, or multiple fQRS. The primary endpoint was a composite of hard cardiac events consisting of heart failure death, sudden cardiac death (SCD), or aborted SCD. The secondary endpoints were all-cause death and arrhythmic event. During a median follow-up of 3.8 years (interquartile range, 1.8-6.2), 31 (11%) patients experienced hard cardiac events. Kaplan-Meier analysis showed that the rates of hard cardiac events and all-cause death were similar in the single-fQRS and no-fQRS groups and higher in the multiple-fQRS group (P = 0.004 and P = 0.017, respectively). Multivariable Cox regression identified that multiple fQRS is a significant predictor of hard cardiac events (hazard ratio, 2.23; 95% confidence interval, 1.07-4.62; P = 0.032). The multiple-fQRS group had the highest prevalence of a diffuse late gadolinium enhancement pattern (no fQRS, 21%; single fQRS, 22%; multiple fQRS, 39%; P < 0.001). CONCLUSION: Multiple fQRS, but not single fQRS, is associated with future hard cardiac events in patients with DCM. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: To evaluate the prognostic impact of fragmented QRS (fQRS) on idiopathic dilated cardiomyopathy (DCM). METHODS AND RESULTS: We conducted a prospective observational study of 290 consecutive patients with DCM (left ventricular ejection fraction ≤ 40%) and narrow QRS who underwent cardiac magnetic resonance. We defined fQRS as the presence of various RSR' patterns in ≥2 contiguous leads representing the anterior (V1-V5), inferior (II, III, and aVF), or lateral (I, aVL, and V6) myocardial segments. Multiple fQRS was defined as the presence of fQRS in ≥2 myocardial segments. Patients were divided into three groups: no fQRS, single fQRS, or multiple fQRS. The primary endpoint was a composite of hard cardiac events consisting of heart failure death, sudden cardiac death (SCD), or aborted SCD. The secondary endpoints were all-cause death and arrhythmic event. During a median follow-up of 3.8 years (interquartile range, 1.8-6.2), 31 (11%) patients experienced hard cardiac events. Kaplan-Meier analysis showed that the rates of hard cardiac events and all-cause death were similar in the single-fQRS and no-fQRS groups and higher in the multiple-fQRS group (P = 0.004 and P = 0.017, respectively). Multivariable Cox regression identified that multiple fQRS is a significant predictor of hard cardiac events (hazard ratio, 2.23; 95% confidence interval, 1.07-4.62; P = 0.032). The multiple-fQRS group had the highest prevalence of a diffuse late gadolinium enhancement pattern (no fQRS, 21%; single fQRS, 22%; multiple fQRS, 39%; P < 0.001). CONCLUSION: Multiple fQRS, but not single fQRS, is associated with future hard cardiac events in patients with DCM. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Can Hasdemir; Hatice Sahin; Gulten Duran; Mehmet N Orman; Umut Kocabas; Serdar Payzin; Mehmet Aydin; Charles Antzelevitch Journal: J Arrhythm Date: 2022-05-06
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