Yaman Mehmet, Arslan Ugur, Bayramoglu Adil, Bektas Osman, Gunaydin Zeki Yuksel, Kaya Ahmet
University of Health Sciences, Samsun Training and Research Hospital, Samsun, Turkey; Ordu University, Education and Research Hospital, Cardiology Department, Ordu, Turkey.
University of Health Sciences, Samsun Training and Research Hospital, Samsun, Turkey.
Rev Port Cardiol (Engl Ed). 2018 Jun;37(6):469-475. doi: 10.1016/j.repc.2017.09.022.
The aim of this study was to measure epicardial adipose tissue (EAT) and to assess left ventricular (LV) systolic and diastolic function in a healthy population grouped according to the presence of fragmented QRS (fQRS).
In this prospective case-control study, the study population consisted of 308 healthy individuals who were divided into two groups according to the existence of fQRS: 180 fQRS(+) individuals (with fQRS), and 128 age- and gender-matched fQRS(-) individuals (without fQRS). These individuals were assessed for EAT thickness and subclinical myocardial dysfunction using transthoracic echocardiography including strain imaging.
The baseline clinical characteristics were similar between groups. EAT thickness was significantly increased in fQRS(+) individuals (0.59 vs. 0.44 mm, p<0.001). LV global longitudinal strain, reflecting systolic function (19.62±3.05 vs. 20.95±2.36, p<0.001) and E/A ratio, reflecting diastolic function (0.95±0.30 vs. 1.10±0.37, p<0.001), were decreased, revealing subclinical myocardial dysfunction, in fQRS(+) individuals.
The presence of fQRS on the admission ECG is associated with increased EAT and pronounced subclinical LV systolic and diastolic dysfunction in a healthy population. Further studies with larger patient groups are needed to clarify the exact pathophysiological mechanisms underlying these findings in healthy populations.
本研究旨在测量健康人群中的心外膜脂肪组织（EAT），并根据碎裂QRS波（fQRS）的存在情况对左心室（LV）的收缩和舒张功能进行评估。
在这项前瞻性病例对照研究中，研究人群包括308名健康个体，根据fQRS的存在情况分为两组：180名fQRS（+）个体（有fQRS）和128名年龄及性别匹配的fQRS（-）个体（无fQRS）。使用包括应变成像在内的经胸超声心动图对这些个体的EAT厚度和亚临床心肌功能障碍进行评估。
两组之间的基线临床特征相似。fQRS（+）个体的EAT厚度显著增加（0.59对0.44毫米，p<0.001）。反映收缩功能的LV整体纵向应变（19.62±3.05对20.95±2.36，p<0.001）和反映舒张功能的E/A比值（0.95±0.30对1.10±0.37，p<0.001）在fQRS（+）个体中降低，提示存在亚临床心肌功能障碍。
入院心电图上fQRS的存在与健康人群中EAT增加以及明显的亚临床LV收缩和舒张功能障碍相关。需要对更大的患者群体进行进一步研究，以阐明健康人群中这些发现背后的确切病理生理机制。
