Bekar Lütfü, Kalçık Macit, Çelik Oğuzhan, Alp Çağlar, Yetim Mucahit, Doğan Tolga, Ekinözü İsmail, Karaarslan Osman, Çamkıran Volkan, Karavelioğlu Yusuf, Gölbaşı Zehra
Department of Cardiology, Hitit University Faculty of Medicine, Çorum, Turkey.
Department of Cardiology, Hitit University Corum Training and Research Hospital, Turkey.
J Clin Ultrasound. 2019 Jul;47(6):345-350. doi: 10.1002/jcu.22683. Epub 2019 Jan 4.
Epicardial adipose tissue (EAT) is a cardiometabolic risk factor, and its possible relationship with hypertension has been reported previously. Fragmented QRS (fQRS) detected on electrocardiography (ECG) has been demonstrated to be a marker of myocardial fibrosis. In this study, we aimed to investigate the relationship between the thickness of EAT, and presence of fQRS in hypertensive patients.
Consecutive patients who were diagnosed with hypertension were included in the study. ECG and transthoracic echocardiography (TTE) were performed to all patients. fQRS was defined as additional R' wave or notching/splitting of S wave in two contiguous ECG leads. Thickness of EAT was measured by TTE.
This study enrolled 69 hypertensive patients with fQRS on ECG and 45 hypertensive patients without fQRS as the control group. Age (P = .869), and gender distribution (P = .751) were similar in both groups. Left atrial diameter (P = .012), interventricular septal thickness (P < .001), posterior wall thickness (P < .001), left ventricular ejection fraction (P = .009), left ventricular mass (P = .006), left ventricular mass ındex (P = .014), left ventricular hypertrophy (P = .003), and EAT thickness (P < .001) were found to be significantly increased in patients with fQRS. In multivariate analysis, among these variables only EAT was observed to be an independent predictor of fQRS (odds ratio:3.306 [95% confidence interval, 0.030-0.118], P = .001).
A significant association exists between the presence of fQRS and EAT thickness in hypertensive patients. The presence of fQRS, just as EAT thickness, may be used as a cardiometabolic risk factor in hypertensive patients.
心外膜脂肪组织（EAT）是一种心脏代谢危险因素，其与高血压之间的可能关系此前已有报道。心电图（ECG）检测到的碎裂QRS波（fQRS）已被证明是心肌纤维化的一个标志物。在本研究中，我们旨在探讨高血压患者中EAT厚度与fQRS波存在之间的关系。
连续入选被诊断为高血压的患者。对所有患者进行ECG和经胸超声心动图（TTE）检查。fQRS波定义为两个相邻ECG导联中出现额外的R'波或S波切迹/分裂。通过TTE测量EAT厚度。
本研究纳入69例ECG有fQRS波的高血压患者和45例无fQRS波的高血压患者作为对照组。两组的年龄（P = 0.869）和性别分布（P = 0.751）相似。有fQRS波的患者左心房直径（P = 0.012）、室间隔厚度（P < 0.001）、后壁厚度（P < 0.001）、左心室射血分数（P = 0.009）、左心室质量（P = 0.006）、左心室质量指数（P = 0.014）、左心室肥厚（P = 0.003）和EAT厚度（P < 0.001）均显著增加。多因素分析中，在这些变量中仅观察到EAT是fQRS波的独立预测因素（比值比：3.306 [95%置信区间，0.030 - 0.118]，P = 0.001）。
高血压患者中fQRS波的存在与EAT厚度之间存在显著关联。fQRS波的存在与EAT厚度一样，可作为高血压患者的心脏代谢危险因素。
