碎裂QRS波群对高血压患者左心室肥厚的识别意义
Significance of fragmented QRS complexes for identifying left ventricular hypertrophy in patients with hypertension.
作者信息
Zhang Baowei, Zhen Ya, Shen Dongli, Zhang Guohui
机构信息
Department of Cardiology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
出版信息
Ann Noninvasive Electrocardiol. 2015 Mar;20(2):175-80. doi: 10.1111/anec.12212. Epub 2014 Sep 18.
BACKGROUND
Fragmented QRS complexes (fQRS) were associated with left ventricular mass (LVM) in hypertensive patients. Our study aimed to investigate the association between fQRS and left ventricular hypertrophy (LVH) in hypertensive patients.
METHODS
Two hundred thirty-six hypertensive patients were divided into fQRS group and non-fQRS group. fQRS were defined as the presence of an additional R wave, notching in the R or S wave, or the presence of >1 R' in two contiguous leads. Echocardiography was used to detect LVH.
RESULTS
Patients with fQRS had higher levels of LVM than patients without fQRS (181.55 ± 65.64 g vs. 149.21 ± 35.08 g, P < 0.001). Receiver operating characteristic curves showed areas under the curve was 0.62 for fQRS (95% CI 0.54-0.69, P = 0.003). In univariate analyses, the presence of fQRS on ECG was positively associated with LVM. Multiple regression analyses found fQRS was associated with LVM, independently.
CONCLUSION
fQRS is a common electrocardiographic phenomenon in patients with hypertension. Although the diagnostic value for LVH is limited, the presence of fQRS on ECG is associated with a higher risk for worse LVH.
背景
碎裂QRS波群（fQRS）与高血压患者的左心室质量（LVM）相关。我们的研究旨在探讨高血压患者中fQRS与左心室肥厚（LVH）之间的关联。
方法
236例高血压患者被分为fQRS组和非fQRS组。fQRS被定义为在两个相邻导联中出现额外的R波、R波或S波切迹，或>1个R'波。采用超声心动图检测LVH。
结果
fQRS患者的LVM水平高于无fQRS患者（181.55±65.64 g对149.21±35.08 g，P<0.001）。受试者工作特征曲线显示，fQRS的曲线下面积为0.62（95%CI 0.54-0.69，P=0.003）。在单因素分析中，心电图上fQRS的存在与LVM呈正相关。多元回归分析发现fQRS与LVM独立相关。
结论
fQRS是高血压患者常见的心电图现象。虽然对LVH的诊断价值有限，但心电图上fQRS的存在与LVH恶化风险较高相关。
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