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Relationship between fragmented QRS complex and early left ventricular dysfunction after mitral valve repair.
Filiz Kizilirmak Yılmaz1, Beytullah Cakal1, Fatih Yılmaz2
1Medipol University Faculty of Medicine, Cardiology Department, Istanbul, Turkey.
Journal of Electrocardiology
|March 27, 2024
Summary
Fragmented QRS (fQRS) on preoperative ECG predicts early left ventricular (LV) dysfunction after mitral valve repair (MVR). This cost-effective test can identify patients at higher risk for LV dysfunction post-MVR.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Preoperative left ventricular ejection fraction (PreLVEF) and end-systolic diameter (PreESD) predict postoperative LV dysfunction after mitral valve repair (MVR).
- Fragmented QRS (fQRS) on electrocardiography (ECG) indicates myocardial fibrosis.
- The study investigates fQRS as a predictor of postoperative LV dysfunction in severe primary mitral regurgitation (MR) due to mitral valve prolapse (MVP).
Purpose of the Study:
- To evaluate the relationship between preoperative fQRS and early postoperative LV dysfunction after MVR.
- To determine if fQRS is an independent predictor of LV dysfunction post-MVR.
Main Methods:
- Retrospective analysis of 49 patients undergoing successful MVR for severe MR from 2019-2022.
- Collected preoperative and postoperative echocardiographic data.
- Assessed demographic, echocardiographic, operative, and postoperative parameters, defining LV dysfunction as LVEF < 60%.
Main Results:
- 22 patients (44.9%) had fQRS; 36.7% experienced postoperative LV dysfunction.
- fQRS was significantly more prevalent in patients with postoperative LV dysfunction (66.7% vs 32.3%, p=0.036).
- Multivariate analysis identified fQRS as a significant independent predictor of postoperative LV dysfunction (p=0.003, OR=4.28).
Conclusions:
- Fragmented QRS (fQRS) predicts early postoperative LV dysfunction following mitral valve repair (MVR).
- fQRS is a readily available and cost-effective tool for risk stratification in MVR patients.
- This finding supports the clinical utility of fQRS in managing patients undergoing MVR.
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