Bazoukis George, Garcia-Zamora Sebastian, Çinier Göksel, Lee Sharen, Elvin Gul Enes, Álvarez-García Jesús, Miana Gabi, Hayıroğlu Mert İlker, Tse Gary, Liu Tong, Baranchuk Adrian
Department of Cardiology, Larnaca General Hospital, Larnaca 6036, Cyprus.
Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia 2414, Cyprus.
World J Cardiol. 2022 Sep 26;14(9):483-495. doi: 10.4330/wjc.v14.i9.483.
Cardiac magnetic resonance (CMR) is a unique tool for non-invasive tissue characterization, especially for identifying fibrosis.
To present the existing data regarding the association of electrocardiographic (ECG) markers with myocardial fibrosis identified by CMR - late gadolinium enhancement (LGE).
A systematic search was performed for identifying the relevant studies in Medline and Cochrane databases through February 2021. In addition, we conducted a relevant search by (RCA) (https://www.referencecitationanalysis.com).
A total of 32 studies were included. In hypertrophic cardiomyopathy (HCM), fragmented QRS (fQRS) is related to the presence and extent of myocardial fibrosis. fQRS and abnormal Q waves are associated with LGE in ischemic cardiomyopathy patients, while fQRS has also been related to fibrosis in myocarditis. Selvester score, abnormal Q waves, and notched QRS have also been associated with LGE. Repolarization abnormalities as reflected by increased Tp-Te, negative T-waves, and higher QT dispersion are related to myocardial fibrosis in HCM patients. In patients with Duchenne muscular dystrophy, a significant correlation between fQRS and the amount of myocardial fibrosis as assessed by LGE-CMR was observed. In atrial fibrillation patients, advanced inter-atrial block is defined as P-wave duration ≥ 120 ms, and biphasic morphology in inferior leads is related to left atrial fibrosis.
Myocardial fibrosis, a reliable marker of prognosis in a broad spectrum of cardiovascular diseases, can be easily understood with an easily applicable ECG. However, more data is needed on a specific disease basis to study the association of ECG markers and myocardial fibrosis as depicted by CMR.
心脏磁共振成像（CMR）是一种用于无创组织特征分析的独特工具，尤其适用于识别纤维化。
介绍有关心电图（ECG）标志物与通过CMR识别的心肌纤维化——延迟钆增强（LGE）之间关联的现有数据。
通过对医学文献数据库（Medline）和考克兰系统评价数据库进行系统检索，以识别截至2021年2月的相关研究。此外，我们还通过（RCA）（https://www.referencecitationanalysis.com）进行了相关检索。
共纳入32项研究。在肥厚型心肌病（HCM）中，碎裂QRS波（fQRS）与心肌纤维化的存在和程度相关。fQRS波和异常Q波与缺血性心肌病患者的LGE相关，而fQRS波也与心肌炎中的纤维化有关。塞尔维斯特评分、异常Q波和切迹QRS波也与LGE相关。肥厚型心肌病患者中，Tp-Te间期延长、T波倒置和QT离散度增加所反映的复极异常与心肌纤维化相关。在杜兴氏肌营养不良患者中，观察到fQRS波与通过LGE-CMR评估的心肌纤维化量之间存在显著相关性。在心房颤动患者中，晚期房间阻滞定义为P波时限≥120 ms，下壁导联的双相形态与左心房纤维化有关。
心肌纤维化是广泛心血管疾病预后的可靠标志物，通过易于应用的心电图即可轻松理解。然而，需要更多基于特定疾病的数据来研究心电图标志物与CMR所描绘的心肌纤维化之间的关联。
