Dehghani Mohammad Reza, Rostamzadeh Alireza, Abbasnezhad Ali, Shariati Akram, Nejatisafa Saeid, Rezaei Yousef
Department of Cardiology Urmia University of Medical Sciences Urmia Iran.
Heart Valve Disease Research Center Rajaie Cardiovascular Medical and Research Center Iran University of Medical Sciences Tehran Iran.
J Arrhythm. 2019 Dec 3;36(2):335-340. doi: 10.1002/joa3.12284. eCollection 2020 Apr.
Fragmented QRS (fQRS) complex on routine 12-lead electrocardiogram (ECG) predicts adverse outcomes in patients with cardiovascular diseases. In addition, it has been found to be associated with subclinical myocardial dysfunction in chronic diseases. We sought to investigate the relationship between the presence of fQRS with the myocardial functions in individuals free from known systemic cardiovascular diseases.
In a case-control study, we evaluated normal individuals from March 2017 to February 2018. All participants underwent a 2-dimensional transthoracic echocardiographic examination using tissue Doppler imaging (TDI) and speckle-tracking echocardiography. In addition, all participants were examined using a 12-lead surface ECG, and patients with fQRS and a group of age- and sex-matched controls without fQRS were enrolled in our study.
The patients' mean age was 40.3 ± 10.7 and 35.4 ± 11.2 years in fQRS-positive and fQRS-negative groups, respectively ( = .110). Patients with fQRS had significantly lower values of apical left ventricular global longitudinal strain (LV GLS) in 2-chamber (16.9 ± 2.5 vs. 20.5 ± 3.3, < .001), 4-chamber (16.9 ± 3.4 vs. 20.1 ± 3, = .001), LAX views (17.7 ± 2.8 vs. 20.8 ± 3.5, = .001), and averaged LV GLS (17 ± 2.6 vs. 20.4 ± 2.7, < .001) values compared to patients without fQRS. In a multivariate analysis, averaged LV GLS and smoking history were independent predictors for positive fQRS.
The presence of fQRS on 12-lead ECG in healthy population was associated with lower values of LV GLS compared to normal individuals without fQRS.
常规12导联心电图（ECG）上的碎裂QRS波（fQRS）可预测心血管疾病患者的不良预后。此外，还发现其与慢性疾病中的亚临床心肌功能障碍有关。我们旨在研究无已知全身性心血管疾病个体中fQRS的存在与心肌功能之间的关系。
在一项病例对照研究中，我们评估了2017年3月至2018年2月的正常个体。所有参与者均接受了使用组织多普勒成像（TDI）和斑点追踪超声心动图的二维经胸超声心动图检查。此外，所有参与者均接受了12导联体表心电图检查，fQRS患者和一组年龄及性别匹配的无fQRS对照组纳入我们的研究。
fQRS阳性组和fQRS阴性组患者的平均年龄分别为40.3±10.7岁和35.4±11.2岁（P = 0.110）。与无fQRS的患者相比，fQRS患者在两腔心（16.9±2.5对20.5±3.3，P < 0.001）、四腔心（16.9±3.4对20.1±3，P = 0.001）、左前斜位（LAX）视图（17.7±2.8对20.8±3.5，P = 0.001）以及平均左心室整体纵向应变（LV GLS）（17±2.6对20.4±2.7，P < 0.001）值显著更低。在多变量分析中，平均LV GLS和吸烟史是fQRS阳性的独立预测因素。
与无fQRS的正常个体相比，健康人群12导联心电图上fQRS的存在与较低的LV GLS值相关。
