Open AccessFragmented QRS Complexes Are Associated with Increased Left Ventricular Mass in Patients with Essential Hypertension
Author(s) -
Kadi Hasan,
Kevser Ayşe,
Ozturk Ahmet,
Koc Fatih,
Ceyhan Koksal
Publication year - 2013
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12070
Subject(s) - medicine , cardiology , left ventricular hypertrophy , ejection fraction , odds ratio , essential hypertension , body mass index , qrs complex , muscle hypertrophy , mass index , heart failure , blood pressure
Background Left ventricular hypertrophy (LVH) is an independent predictor of poor prognosis in patients with hypertension. In hypertensive hypertrophy, the pathophysiological mechanism is the accumulation of collagen in the myocardium. Fragmented QRS (fQRS) complexes are associated with myocardial fibrosis. Methods The study population included 90 patients with hypertension and a normal coronary angiogram. The fQRS was defined as the presence of an additional R wave (R′), notching of the R or S wave, or the presence of fragmentation in two contiguous leads corresponding to a major coronary artery. Echocardiographic examinations were performed according to the recommendations of the American Society of Echocardiography. Results Forty‐five patients who had fQRS and were suitable for the study criteria were compared with 45 age‐ and gender‐matched patients who did not have fQRS according to demographic data and echocardiographic findings. The left ventricular (LV) mass index (g/m 2 ) was significantly higher (P < 0.001) in the group with fQRS. The wall thickness, diameter, volume, and ejection fraction (EF) were higher in this group (P < 0.001). Concentric and eccentric hypertrophy were also higher in this group (P < 0.001). In the logistic regression analysis, fQRS on ECG was an indicator of LVH in hypertensive patients (B = 0.064; P < 0.001; odds ratio = 1.066; 95% confidence interval = 1.041–1.092) Conclusion The LV mass index of the hypertensive patients who had fQRS on their ECGs was significantly higher than that of the patients who did not, and fQRS on ECG was an important indicator of LVH in hypertensive patients.