Department of Cardiology, School of Medicine, Gaziosmanpasa University, Kaleardi, 60030, Tokat, Turkey.
High Blood Press Cardiovasc Prev. 2021 Jan;28(1):57-62. doi: 10.1007/s40292-020-00422-w. Epub 2020 Nov 20.
A narrow fragmented QRS complex (fQRS) indicates myocardial fibrosis and hypertensive cardiomyopathy in hypertensive patients. However, no study has investigated the importance of localization of fQRS on electrocardiography (ECG) in these subjects.
To investigate the association between circadian blood pressure (BP) pattern and localization of fQRS on ECG.
A total of 291 hypertensive patients who had fQRS in anterior or inferior leads were included into the study. Patients were divided into two groups according to localization of fQRS in inferior or anterior leads. All patients underwent a 24-h ambulatory blood pressure monitoring for detailed evaluation of circadian BP pattern. The association between localization of fQRS and non-dipping was investigated.
Among study population, 182 (62.5%) patients had fQRS in inferior leads and 109 (37.5%) patients had fQRS in anterior leads. The frequency of patients with non-dipping BP pattern was significantly higher in patients with fQRS in anterior leads compared to patients with fQRS in inferior leads (47.7% vs 24.1%, p < 0.001). Moreover, the frequency of fQRS in anterior leads was significantly higher in non-dippers compared to dippers (64.6% vs. 24.1%, p < 0.001). Furthermore, in multivariate analysis, presence of fQRS in anterior leads was found to be an independent predictor of non-dipping BP pattern in hypertensive patients (OR: 1.748, 95% CI 1.362-2.446, p < 0.001).
Presence of fQRS in anterior leads is significantly associated with non-dipping BP pattern in hypertensive patients. Therefore, localization of fQRS on ECG may provide useful information regarding further risk assessment of hypertensive subjects.
在高血压患者中，窄而碎裂的 QRS 波群（fQRS）表示心肌纤维化和高血压性心肌病。然而，尚无研究调查心电图（ECG）上 fQRS 的定位在这些患者中的重要性。
探讨昼夜血压（BP）模式与 ECG 上 fQRS 定位之间的关系。
共纳入 291 例心电图前或下导联存在 fQRS 的高血压患者。根据 fQRS 在下或前导联的定位，将患者分为两组。所有患者均进行 24 小时动态血压监测，以详细评估昼夜 BP 模式。研究了 fQRS 定位与非杓型的关系。
在研究人群中，182 例（62.5%）患者下导联存在 fQRS，109 例（37.5%）患者前导联存在 fQRS。与下导联 fQRS 患者相比，前导联 fQRS 患者非杓型血压模式的患者比例显著更高（47.7%比 24.1%，p<0.001）。此外，非杓型患者前导联 fQRS 的发生率明显高于杓型患者（64.6%比 24.1%，p<0.001）。此外，多变量分析发现，前导联存在 fQRS 是高血压患者非杓型 BP 模式的独立预测因子（OR：1.748，95%CI 1.362-2.446，p<0.001）。
前导联 fQRS 的存在与高血压患者的非杓型 BP 模式显著相关。因此，ECG 上 fQRS 的定位可为高血压患者的进一步风险评估提供有用信息。
