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The predictive value of fragmented QRS for severe coronary stenosis in patients undergoing coronary CT angiography
Eyyup Tusun1, Necmettin Korucuk2, Mustafa Çetin1
1Department of Cardiology, Şanlıurfa Mehmet Akif İnan Education and Research Hospital, Şanlıurfa, Turkey.
Insights
Fragmented QRS (fQRS) on ECG is linked to significant coronary artery stenosis (≥70%) detected by coronary computed tomography angiography (CCTA). This ECG finding may help predict severe blockages in coronary arteries.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Electrocardiography
Background:
- Coronary artery disease (CAD) is a leading global cause of mortality.
- Fragmented QRS (fQRS) is an emerging prognostic marker in cardiovascular disease.
- Coronary computed tomography angiography (CCTA) effectively diagnoses obstructive CAD, with stenosis severity being critical.
Purpose of the Study:
- To investigate the association between fragmented QRS (fQRS) and significant coronary artery stenosis (≥70%) detected by CCTA.
- To evaluate fQRS as a potential predictor of obstructive CAD.
Main Methods:
- 120 patients with angina pectoris symptoms underwent CCTA.
- fQRS was defined by specific ECG criteria (e.g., notching, multiple R' waves) excluding bundle branch blocks.
- Patients were grouped based on the presence (n=58) or absence (n=62) of ≥70% coronary artery stenosis.
Main Results:
- No significant differences in baseline characteristics between groups.
- Higher prevalence of diabetes mellitus, hyperlipidemia, smoking, and fQRS in the ≥70% stenosis group (p<0.05).
- fQRS was significantly more prevalent in patients with ≥70% stenosis (p<0.001) and correlated positively with stenosis severity. Smoking and fQRS were independent predictors of ≥70% stenosis.
Conclusions:
- Fragmented QRS (fQRS) is associated with significant coronary artery stenosis (≥70%) identified by CCTA.
- fQRS may serve as a valuable ECG finding for predicting severe coronary artery stenosis.
Background:
Coronary artery disease (CAD) is the leading cause of death worldwide. Fragmented QRS (fQRS) has emerged as a new prognostic marker in cardiovascular disease. Coronary computed tomography angiography (CCTA) is an effective method to diagnose obstructive CAD. The degree of stenosis determines the severity of the disease.
Methods:
A total of 120 patients admitted to the cardiology outpatient clinic with angina pectoris symptoms were included in the study. The fQRS is defined as the presence of an additional R wave, notching of the R wave, notching of the nadir of the S wave in 2 contiguous leads, or the presence of more than one R' wave without a typical bundle branch block. CCTA was performed on patients with low-moderate risk. The patients were divided into two groups based on the presence (Group 1, n = 58 patients) or the absence (Group 2, n = 62 patients) of ≥70 % coronary artery stenosis.
Results:
The baseline characteristics of the patients were not significantly different. Group 1 had a higher prevalence of DM, hyperlipidemia, smoking, and fQRS compared to Group 2 (p < 0.05, for all). When the subjects were divided into two groups, fQRS (+) and fQRS (-), a statistically significant difference was revealed between the two groups (p < 0.001). A positive correlation was found between fQRS and ≥ 70 % stenosis in CCTA. In the multivariate regression analysis, smoking and fQRS were independent predictors of ≥70 % stenosis in CCTA.
Conclusion:
According to our study, fQRS, an important ECG finding, is associated with ≥70 % stenosis in CCTA and may be evaluated for the prediction of significant coronary stenosis.
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