Yaman Fikriye Karanfil, Doğru Şükran, Karanfil Mustafa, Ezveci Huriye, Arslan Emine, Akkuş Fatih, Acar Ali
Meram Faculty of Medicine, Clinic of Obstetrics and Gynecology Division of Maternal and Fetal Medicine, Necmettin Erbakan University (NEU), Konya, Turkey.
Clinic of Obstetrics and Gynecology Division of Maternal and Fetal Medicine, Konya City Hospital, Konya, Turkey.
Arch Gynecol Obstet. 2024 Dec;310(6):2873-2878. doi: 10.1007/s00404-024-07755-0. Epub 2024 Oct 5.
This study aims to investigate the prevalence, clinical correlates, and prognostic implications of fragmented QRS complexes (fQRS) in pregnant women with preeclampsia (PE), shedding light on the potential role of electrocardiographic markers in identifying cardiac involvement in hypertensive disorders of pregnancy.
Patients with PE and age-matched low-risk control patients were recruited at a tertiary hospital between January 2015 and January 2023. A comprehensive assessment, including heart rate, PR duration, QRS duration, corrected QT duration, and fragmented QRS, was conducted by 12-lead electrocardiography. Baseline clinical characteristics, laboratory parameters, and electrocardiographic findings were compared between the study groups.
128 preeclampsia patients and 122 age- and comorbidity-matched controls were included in the study. The prevalence of fQRS was significantly higher in preeclamptic women compared to normotensive controls (14.1% vs. 3.3%, p = 0.04). ALT levels of pregnant women with preeclampsia and without preeclampsia groups were 43,77 (35.25-48.22) and 23,18 (13.75-33.00) (p: 0.038), respectively. In univariate regression analyses, Na and fragmented QRS were found to be associated with preeclampsia. (p: 0.016 and 0.009, respectively). After multivariable adjustment for variables, Na and fragmented QRS remained strongly associated with preeclampsia (OR: 4.787 (1.556-14.720), p: 0.06; 0.941 (0.893-0.992), p: 0.023, respectively).
This study provides compelling evidence of an association between preeclampsia and fragmented QRS complexes, implicating electrolyte imbalances and hemodynamic stress as potential contributors to myocardial electrical instability in hypertensive disorders of pregnancy. Further research is warranted to validate these findings and improve risk stratification and clinical outcomes in affected women. Number: 2023/4705 Retrospectively Registered.
本研究旨在调查子痫前期(PE)孕妇中碎裂QRS波群(fQRS)的患病率、临床相关性及预后意义,以阐明心电图标志物在识别妊娠高血压疾病中心脏受累情况的潜在作用。
2015年1月至2023年1月期间,在一家三级医院招募了子痫前期患者和年龄匹配的低风险对照患者。通过12导联心电图进行全面评估,包括心率、PR间期、QRS间期、校正QT间期和碎裂QRS波群。比较研究组之间的基线临床特征、实验室参数和心电图结果。
本研究纳入了128例子痫前期患者和122例年龄及合并症匹配的对照。子痫前期女性中fQRS的患病率显著高于血压正常的对照组(14.1%对3.3%,p = 0.04)。子痫前期组和非子痫前期组孕妇的ALT水平分别为43.77(35.25 - 48.22)和23.18(13.75 - 33.00)(p:0.038)。在单因素回归分析中,发现钠和碎裂QRS波群与子痫前期相关。(分别为p:0.016和0.009)。对变量进行多因素调整后,钠和碎裂QRS波群仍与子痫前期密切相关(OR:4.787(1.556 - 14.720),p:0.06;0.941(0.893 - 0.992),p:0.023)。
本研究提供了子痫前期与碎裂QRS波群之间存在关联的有力证据,提示电解质失衡和血流动力学应激可能是妊娠高血压疾病中心肌电不稳定的潜在因素。有必要进一步研究以验证这些发现,并改善受影响女性的风险分层和临床结局。编号:2023/4705 回顾性注册。