非高血压肢端肥大症患者碎裂 QRS 波形成的评估及其与左心室肥厚的关系。
Assessment of fragmented QRS formation and its relationship with left ventricular hypertrophy in nonhypertensive acromegaly patients.
机构信息
Department of Cardiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
Department of Endocrinology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
出版信息
Turk J Med Sci. 2021 Oct 21;51(5):2437-2444. doi: 10.3906/sag-2101-229.
BACKGROUND/AIM: It is known that the presence of fragmented QRS (fQRS) on electrocardiography (ECG) is associated with cardiovascular events. The aim of this study was the evaluation of fQRS formation and its relationship with the left ventricular hypertrophy (LVH) parameters in acromegaly patients.
MATERIALS AND METHODS
In total, 47 previously diagnosed with non-hypertensive acromegaly patients and 48 control subjects were included in the study. ECG and transthoracic echocardiography (TTE) were performed for each participant. Acromegaly patients were divided into two groups according to the fQRS formation on the ECG. Left ventricular wall thicknesses, and left atrial diameter (LAD), left ventricular mass (LVM), left ventricular mass index (LVMi), and relative wall thickness (RWT) were obtained.
RESULTS
In control group 5 (10.4%) and in acromegaly group 17 (36.2%) patients had fQRS on ECG (p = 0.003). LAD [36.0 (34.0–38.0) vs. 38.0 (35.0–41.0) mm, p < 0.001], LVM [155.27 ± 27.00 vs. 173.0 (153.0–235.0) g, p < 0.001], LVMi [83.12 ± 13.19 vs. 92.0 (83.0–118.0) g/m², p < 0.001] and RWT [0.39 ± 0.03 vs. 0.43 (0.41–0.45), p = 0.001] were significantly higher in patients with acromegaly. Disease duration was significantly higher (11.59 ± 1.3 vs. 8.2 ± 1.8 years, p < 0.001) in the fQRS (+) group. LAD [41.0 (39.0–42.5) vs. 37.0 (34.7–38.0) mm, p < 0.001], LVM [219.0 (160.5–254.5) vs. 164.0 (153.0–188.0) g, p = 0.017], LVMi [117.0 (92.5–128.5) vs. 86.0 (82.0–100.2) g/m², p = 0.013] and RWT [0.44 (0.42–0.49) vs. 0.43 (0.40–0.44), p = 0.037] were significantly higher in fQSR (+) acromegaly patients. In multivariate logistic regression analysis, disease duration (odds ratio: 10.05, 95% CI: 1.099–92.012, p = 0.041) and LAD (odds ratio: 2.19, 95% CI: 1.030–4.660, p = 0.042) were found to be the independent predictors of fQRS formation.
CONCLUSION
The results of our study revealed that fQRS (+) acromegaly patients had increased LVH parameters compared to fQRS (-) patients.
背景/目的：心电图（ECG）上存在碎裂 QRS（fQRS）与心血管事件有关。本研究的目的是评估肢端肥大症患者 fQRS 的形成及其与左心室肥厚（LVH）参数的关系。
材料和方法
共纳入 47 例经诊断为非高血压肢端肥大症患者和 48 例对照者。对每位参与者进行心电图和经胸超声心动图（TTE）检查。根据 ECG 上 fQRS 的形成将肢端肥大症患者分为两组。获得左心室壁厚度和左心房直径（LAD）、左心室质量（LVM）、左心室质量指数（LVMi）和相对壁厚度（RWT）。
结果
对照组有 5 例（10.4%）和肢端肥大症组有 17 例（36.2%）患者 ECG 上有 fQRS（p = 0.003）。LAD[36.0（34.0-38.0）与 38.0（35.0-41.0）mm，p < 0.001]、LVM[155.27 ± 27.00 与 173.0（153.0-235.0）g，p < 0.001]、LVMi[83.12 ± 13.19 与 92.0（83.0-118.0）g/m²，p < 0.001]和 RWT[0.39 ± 0.03 与 0.43（0.41-0.45），p = 0.001]在肢端肥大症患者中显著更高。fQRS（+）组的疾病持续时间明显更长（11.59 ± 1.3 与 8.2 ± 1.8 年，p < 0.001）。LAD[41.0（39.0-42.5）与 37.0（34.7-38.0）mm，p < 0.001]、LVM[219.0（160.5-254.5）与 164.0（153.0-188.0）g，p = 0.017]、LVMi[117.0（92.5-128.5）与 86.0（82.0-100.2）g/m²，p = 0.013]和 RWT[0.44（0.42-0.49）与 0.43（0.40-0.44），p = 0.037]在 fQRS（+）肢端肥大症患者中显著更高。多变量逻辑回归分析显示，疾病持续时间（比值比：10.05，95%置信区间：1.099-92.012，p = 0.041）和 LAD（比值比：2.19，95%置信区间：1.030-4.660，p = 0.042）是 fQRS 形成的独立预测因子。
结论
我们的研究结果表明，与 fQRS（-）患者相比，fQRS（+）肢端肥大症患者的 LVH 参数增加。
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