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Abstract
BackgroundSeveral studies addressed the association between fragmented QRS (fQRS) on 12-lead EKG and left ventricular (LV) dysfunction in patients with a variety of cardiovascular disorders. We tested such association in healthy individuals.MethodsOut of 500 healthy participants without -overt cardiovascular disease from the Shiraz Heart Study cohort, we identified 20 subjects with fQRS (cases) and 20 peers without fQRS (controls). Global LV longitudinal strain (GLS) was measured by speckle tracking echocardiography in the two groups. Comparison was made between case and control groups by using chi-square or independent sample t-test or ANOVA.ResultsAge, gender, ejection fraction, LV volume and dimensions did not differ between the case and the control groups. Overall, 14 subjects out of 40 had reduced GLS (≤20%) and 10 of them (25%) had fQRS. GLS was significantly lower in the group with fQRS than in the control group (19.9 ± 1.8 vs 21.4 ± 1.6; p = 0.009).ConclusionsHealthy subjects with fQRS present regional LV systolic dysfunction, assessed by GLS, in the presence of a normal ejection fraction. These data suggest that fQRS may be a promising tool to identify apparently healthy subjects with regional LV systolic dysfunction.
Highlights
Several studies addressed the association between fragmented QRS on 12-lead EKG and left ventricular (LV) dysfunction in patients with a variety of cardiovascular disorders
Mean left ventricular ejection fraction (LVEF) was 59.3 ± 2.9% and the mean Global LV longitudinal strain (GLS) was 20.7 ± 1.8 which were within the normal range [17, 19]
GLS was significantly lower in the group with fragmented QRS (fQRS) than the control group (Table 4)
Summary
Several studies addressed the association between fragmented QRS (fQRS) on 12-lead EKG and left ventricular (LV) dysfunction in patients with a variety of cardiovascular disorders. We tested such association in healthy individuals. Left ventricular (LV) systolic function is an important clinical finding in cardiology. It is applied in prevention, diagnosis, prognostication, and treatment ina variety of cardiovascular conditions. Less than two decades ago, fragmentation of QRS complex (fQRS) was coined on 12-lead EKG [3]. It has been suggested that fQRS is more sensitive than Q-wave for identifying myocardial scars [11]. Adverse major cardiac events have been predicted by fQRS in these patients in spite of a normal ejection fraction [12]
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