Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; Department of Cardiovascular Medicine, IMS Katsushika Heart Center, Tokyo, Japan.
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
J Cardiol. 2022 Mar;79(3):446-452. doi: 10.1016/j.jjcc.2021.10.022. Epub 2021 Nov 17.
Multiple spikes within the QRS complex, known as fragmented QRS (fQRS), are associated with the occurrences of ventricular arrhythmic events (VAEs) in patients with Brugada syndrome and hypertrophic cardiomyopathy. However, the association between fQRS and occurrence of VAEs in patients with cardiac sarcoidosis (CS) has not been elucidated.
We evaluated the associations between fQRS and cardiac events including VAEs [non-sustained ventricular tachycardia (NSVT), sustained ventricular tachycardia (VT), and ventricular fibrillation (VF)], hospitalization for heart failure, and all-cause death in 68 patients with CS (30 patients with fQRS vs. 38 patients without fQRS) over a 5-year period.
Cardiac events occurred in 22 patients with fQRS and 18 patients without fQRS (73% vs. 47%, p=0.009). Of the cardiac events that occurred in CS patients, VAEs occurred more frequently in patients with fQRS than in patients without fQRS (VAEs: 70% vs. 45%, p=0.017; NSVT: 70% vs. 45%, p=0.010; VT: 43% vs. 18%, p=0.011, and VF: 6.7% vs. 2.6%, p=0.34), whereas there was no significant difference in hospitalization for heart failure or all-cause death between patients with and those without fQRS (hospitalization for heart failure: 6.7% vs. 5.3%, p=0.75; all-cause death: 6.7% vs. 5.3%, p=0.64). Multivariate analysis showed that fQRS in the baseline electrocardiogram was independently associated with VAEs (hazard ratio: 2.21, 95% confidence interval: 1.15-4.25, p=0.017).
fQRS is a predictor of VAEs in patients with CS.
在 Brugada 综合征和肥厚型心肌病患者中，QRS 复合波内出现多个尖峰（碎裂 QRS，fQRS）与室性心律失常事件（VAEs）的发生有关。然而，fQRS 与心脏结节病（CS）患者 VAEs 发生之间的关系尚未阐明。
我们评估了 fQRS 与心脏事件（包括非持续性室性心动过速[NSVT]、持续性室性心动过速[VT]和心室颤动[VF]）、心力衰竭住院和全因死亡之间的关系，纳入 68 例 CS 患者（30 例有 fQRS，38 例无 fQRS），随访 5 年。
fQRS 组和无 fQRS 组分别有 22 例和 18 例患者发生心脏事件（73% vs. 47%，p=0.009）。在 CS 患者发生的心脏事件中，fQRS 组患者的 VAEs 发生率高于无 fQRS 组（VAEs：70% vs. 45%，p=0.017；NSVT：70% vs. 45%，p=0.010；VT：43% vs. 18%，p=0.011，VF：6.7% vs. 2.6%，p=0.34），但 fQRS 组与无 fQRS 组心力衰竭住院和全因死亡之间无显著差异（心力衰竭住院：6.7% vs. 5.3%，p=0.75；全因死亡：6.7% vs. 5.3%，p=0.64）。多变量分析显示，基线心电图 fQRS 与 VAEs 独立相关（危险比：2.21，95%置信区间：1.15-4.25，p=0.017）。
fQRS 是 CS 患者 VAEs 的预测因子。
