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高血压合并碎裂QRS波群患者细胞间黏附分子-1水平的研究。

Investigation of ICAM-1 levels in hypertensive patients with fragmented QRS complexes.

作者信息

Bekar Lütfü, Kalçık Macit, Katar Muzaffer, Yetim Mucahit, Çelik Oğuzhan, Doğan Tolga, Karavelioğlu Yusuf, Gölbaşı Zehra

机构信息

Department of Cardiology, Hitit University Faculty of Medicine, Çorum, Turkey.

Department of Biochemistry, Gaziosmanpasa University Faculty of Medicine, Tokat, Turkey.

出版信息

Acta Cardiol. 2020 Apr;75(2):123-129. doi: 10.1080/00015385.2018.1555200. Epub 2019 Jan 16.

Abstract

Fragmented QRS (fQRS) detected on a 12-lead electrocardiogram (ECG) has been demonstrated to be a marker of myocardial fibrosis. Intercellular adhesion molecule-1 (ICAM-1) is a protein which plays an important role in fibro-inflammatory processes. In this study, we aimed to investigate the relationship between ICAM-1 levels and the presence of fQRS in hypertensive patients. Ninety consecutive patients who were diagnosed with hypertension were included in the study. ECG and transthoracic echocardiography were performed to all patients. fQRS was defined as additional R' wave or notching/splitting of S wave in two contiguous ECG leads. Serum ICAM-1 levels were measured using the enzyme-linked immunosorbent assay method. Patients were divided into two groups according to the presence of fQRS. A total of 90 patients (female, 65%; mean age: 54.6 ± 8.5 years) were included in the study. fQRS was detected on ECG recordings of 47 (52.2%) patients. The demographic characteristics were similar between the groups. Left atrial diameter ( = .003), interventricular septal thickness ( = .013), posterior wall thickness ( = .01), left ventricular mass ( = .002), left ventricular mass index ( < .001), left ventricular hypertrophy ( = .001), and ICAM-1 levels ( < .001) were found to be significantly increased in fQRS(+) group. In multivariate analysis, only high ICAM-1 level was observed to be an independent predictor for the presence of fQRS (odds ratio: 1.029; 95%Confidence Interval: 1.013-1.045,  < .001). A significant association exists between serum ICAM-1 levels and the presence of fQRS in hypertensive patients. The presence of fQRS may be used as an indicator of inflammation in hypertensive patients.

摘要

在12导联心电图(ECG)上检测到的碎裂QRS波(fQRS)已被证明是心肌纤维化的一个标志物。细胞间黏附分子-1(ICAM-1)是一种在纤维炎症过程中起重要作用的蛋白质。在本研究中,我们旨在探讨高血压患者ICAM-1水平与fQRS波存在之间的关系。本研究纳入了90例连续诊断为高血压的患者。对所有患者进行了心电图和经胸超声心动图检查。fQRS波被定义为两个连续心电图导联中额外的R'波或S波的切迹/分裂。采用酶联免疫吸附测定法测量血清ICAM-1水平。根据fQRS波的存在情况将患者分为两组。本研究共纳入90例患者(女性占65%;平均年龄:54.6±8.5岁)。47例(52.2%)患者的心电图记录中检测到fQRS波。两组间的人口统计学特征相似。发现fQRS波阳性组的左心房直径(P = 0.003)、室间隔厚度(P = 0.013)、后壁厚度(P = 0.01)、左心室质量(P = 0.002)、左心室质量指数(P < 0.001)、左心室肥厚(P = 0.001)和ICAM-1水平(P < 0.001)均显著升高。在多变量分析中,仅观察到高ICAM-1水平是fQRS波存在的独立预测因素(比值比:1.029;95%置信区间:1.013 - 1.045,P < 0.001)。高血压患者血清ICAM-1水平与fQRS波的存在之间存在显著关联。fQRS波的存在可作为高血压患者炎症的一个指标。

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