Eyuboglu Mehmet, Karabag Yavuz, Karakoyun Suleyman, Senarslan Omer, Tanriverdi Zulkif, Akdeniz Bahri
Department of Cardiology, Ilke Medicine Center, Izmir, Turkey.
Department of Cardiology, Kars Kafkas University Hospital, Kars, Turkey.
J Clin Hypertens (Greenwich). 2017 Sep;19(9):861-865. doi: 10.1111/jch.13051. Epub 2017 Jul 18.
In the absence of left ventricular hypertrophy, importance of fragmented QRS complex (fQRS) in individuals with hypertension is unknown. The authors aimed to evaluate the relationship between blood pressure levels and fQRS in the absence of left ventricular hypertrophy. A total of 548 never-treated patients who underwent 24-hour ambulatory blood pressure monitoring were enrolled. The frequency of fQRS was significantly higher in patients with hypertension than normotension (36.4% vs 17.6%, P<.05). Multivariate logistic regression analysis revealed that systolic blood pressure is significantly associated with presence of fQRS on electrocardiography (odds ratio, 0.931; 95% CI, 0.910-0.9521 [P<.001]) even after adjusting for other confounding factors. Receiver operating characteristic analysis revealed a cutoff value of 147.65 mm Hg for systolic blood pressure to predict presence of fQRS (sensitivity: 51%, specificity: 99%, area under the curve=0.764; 95% CI, 0.717-0.811 [P<.001]). fQRS may be a sign of increased blood pressure and may predict higher fibrotic burden in patients with hypertension.
在无左心室肥厚的情况下，高血压患者中碎裂QRS波群（fQRS）的重要性尚不清楚。作者旨在评估无左心室肥厚时血压水平与fQRS之间的关系。共纳入548例接受24小时动态血压监测的未经治疗的患者。高血压患者中fQRS的频率显著高于血压正常者（36.4%对17.6%，P<0.05）。多因素逻辑回归分析显示，即使在调整其他混杂因素后，收缩压仍与心电图上fQRS的存在显著相关（比值比，0.931；95%可信区间，0.910 - 0.9521[P<0.001]）。受试者工作特征分析显示，预测fQRS存在的收缩压截断值为147.65mmHg（敏感性：51%，特异性：99%，曲线下面积 = 0.764；95%可信区间，0.717 - 0.811[P<0.001]）。fQRS可能是血压升高的一个标志，并且可能预测高血压患者更高的纤维化负担。
