The association between fragmented QRS and left ventricular diastolic dysfunction in type 2 diabetes patients with or
Lili Wang1, Linjun Zheng1, Jiayu Hu2
1ECG Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China.
Insights
Fragmented QRS (fQRS) and microalbuminuria (MAU) are independent risk factors for left ventricular diastolic dysfunction (LVDD) in type 2 diabetes mellitus (T2DM). The association between fQRS and LVDD is stronger in patients without MAU.
Area of Science:
- Cardiology
- Diabetology
- Biomarker Research
Background:
- Cardiovascular disease (CVD) is the primary cause of mortality in type 2 diabetes mellitus (T2DM) patients.
- Left ventricular diastolic dysfunction (LVDD) is an early indicator of myocardial impairment in T2DM.
- The roles of fragmented QRS (fQRS) and microalbuminuria (MAU) in LVDD development within T2DM require further investigation.
Purpose of the Study:
- To investigate the independent impact of fQRS and MAU on LVDD in T2DM patients.
- To analyze how varying MAU statuses influence the relationship between fQRS and LVDD.
- To assess the combined utility of fQRS and MAU for cardiovascular risk stratification in T2DM.
Main Methods:
- Electrocardiography (ECG) and echocardiography were performed on 374 T2DM patients.
- Logistic regression analyses were used to determine the association between fQRS, MAU, and LVDD.
- Stratified analysis examined the fQRS-LVDD relationship across different MAU levels.
Main Results:
- fQRS, MAU, and age were identified as independent risk factors for LVDD in T2DM.
- Patients with fQRS had a 3.72-fold increased risk of LVDD; those with MAU had a 4.05-fold increased risk.
- The fQRS-LVDD association was significant in patients without MAU (OR=7.084) but not in those with MAU (OR=1.499).
Conclusions:
- fQRS and MAU are significant independent risk factors for LVDD in T2DM.
- The presence of MAU diminishes the predictive value of fQRS for LVDD.
- Combined assessment of fQRS and MAU may enhance cardiovascular risk evaluation and guide personalized interventions in T2DM.
Background:
Cardiovascular disease (CVD) is the leading cause of death in patients with type 2 diabetes mellitus (T2DM), and left ventricular diastolic dysfunction (LVDD) is considered one of the earliest markers of myocardial dysfunction. Fragmented QRS (fQRS) and microalbuminuria (MAU) are important biomarkers of cardiac electrophysiological changes and CVD, but their relationship with LVDD in T2DM remains unclear. This study aims to explore the impact of fQRS and MAU on LVDD in T2DM patients and to analyze whether the association between fQRS and LVDD differs across varying MAU statuses.
Methods:
A total of 374 patients with T2DM were ultimately enrolled in this study. Twelve-lead electrocardiography (ECG) and echocardiography were performed, and the patients' baseline characteristics, laboratory results, and echocardiographic parameters were collected. Univariate and multivariate logistic regression analyses were conducted to assess the association between fQRS, MAU, and LVDD in T2DM patients. A stratified analysis was performed to examine the relationship between fQRS and LVDD across different MAU statuses.
Results:
The mean age of the T2DM patients was 57.19±12.47 years, and 62.57% were male. fQRS, MAU, and age were independent risk factors for LVDD in patients with T2DM. The risk of developing LVDD was 3.72 times higher in patients with fQRS compared to those without fQRS [95% CI=2.125-6.513, P<0.0001]. The risk of LVDD was 4.05 times higher in patients with MAU compared to those without MAU [95% CI=2.252-7.282, P<0.0001]. For each additional year of age, the risk of LVDD increased by 5.2% [95% CI=1.022-1.084, P=0.001]. Stratified analysis based on MAU status revealed that in patients without MAU, the association between fQRS and LVDD was stronger [OR=7.084, 95% CI=3.255-15.419, P<0.0001]. However, in patients with MAU, the relationship between fQRS and LVDD was no longer significant [OR=1.499, 95% CI=0.603-3.722, P=0.383].
Conclusions:
Our study found that both fQRS and MAU are independent risk factors for LVDD in patients with T2DM. The presence of fQRS increased the risk of LVDD by 3.72 times, while MAU increased the risk by 4.05 times. Stratified analysis further revealed that in patients without MAU, the association between fQRS and LVDD was significantly stronger (OR=7.084, P<0.0001), while in patients with MAU, this association was no longer significant (P=0.383). These findings suggest that combining the detection of fQRS and MAU may provide valuable information for cardiovascular risk assessment in T2DM patients, helping to develop personalized intervention strategies and ultimately improving patient prognosis.
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