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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
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Fragmented QRS complexes are associated with increased left ventricular mass in patients with essential hypertension

Hasan Kadi1, Ayşe Kevser, Ahmet Ozturk

  • 1Gaziosmanpasa University Faculty of Medicine, Department of Cardiology, Tokat, Turkey.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|December 6, 2013
PubMed

Insights

Fragmented QRS (fQRS) on ECG indicates left ventricular hypertrophy (LVH) in hypertension patients. This finding suggests fQRS is a valuable indicator for identifying LVH and assessing cardiac fibrosis risk.

Area of Science:

  • Cardiology
  • Clinical Electrophysiology
  • Cardiac Imaging

Background:

  • Left ventricular hypertrophy (LVH) is a significant predictor of adverse outcomes in hypertensive individuals.
  • Myocardial fibrosis, characterized by collagen accumulation, is a key pathological feature in hypertensive cardiac hypertrophy.
  • Fragmented QRS (fQRS) complexes on electrocardiograms (ECGs) have been linked to myocardial fibrosis.

Purpose of the Study:

  • To investigate the association between fragmented QRS (fQRS) and left ventricular hypertrophy (LVH) in patients with hypertension.
  • To determine if fQRS can serve as a marker for myocardial fibrosis in the context of hypertensive heart disease.

Main Methods:

  • The study included 90 hypertensive patients with normal coronary angiograms.
  • fQRS was defined by specific criteria on ECG, including notching or fragmentation in leads reflecting major coronary arteries.
  • Echocardiography was used to assess left ventricular structure and function according to American Society of Echocardiography guidelines.

Main Results:

  • Patients with fQRS (n=45) exhibited significantly higher left ventricular mass index compared to those without fQRS (n=45) (P < 0.001).
  • Increased left ventricular wall thickness, diameter, volume, and reduced ejection fraction were observed in the fQRS group (P < 0.001).
  • Logistic regression confirmed fQRS as an independent indicator of LVH in hypertensive patients (OR = 1.066, P < 0.001).

Conclusions:

  • Hypertensive patients with fQRS demonstrate significantly greater left ventricular mass index.
  • fQRS on ECG is an important and independent indicator of left ventricular hypertrophy in hypertensive individuals.
  • fQRS may serve as a non-invasive marker for detecting myocardial fibrosis and LVH in hypertension.
Abstract

Keywords:
fragmented QRShypertensionleft ventricular hypertrophy

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