Fragmented QRS complex as a marker of myocardial fibrosis in patients with coronary artery disease

Abstract

Aim– to analyze the relationship between fQRS and myocardial fibrosis in CAD patients using SPECT.
 Material and methods.Retrospectively, we have analyzed the anamnesis and examinations of 116 patients with suspected coronary heart disease. The fQRS was assessed according to the criteria of Das M. et al., 2006, along with the presence of a pathological Q wave and a slow increase in the amplitude of the R wave. We analysed the transient myocardial ischemia and/or myocardial scarring using stress/rest SPECT with technetium-99m.
 Results.fQRS was significantly more frequently detected in patients with stable and partially reversible perfusion defects – 44.1% and 52.2%, respectively, versus 13.0% and 5.5% in patients without perfusion defects or with reversible perfusion defects, p 0.05. Among 28 patients with QRS fragmentation and myocardial fibrosis, 19 (67.8%) had classical signs of fibrosis on the ECG, 9 (32.1%) had no ECG-registered fibrosis but fQRS was detected. The sensitivity of fQRS marker in detecting myocardial fibrosis reached 84.4%, the specificity was 63.3%.
 Conclusion.fQRS complex is an informative marker for detecting myocardial scarring in patients with coronary artery disease. Analysis of fQRS in daily clinical practice may increase the diagnostic value of electrocardiography in the detection of fibrosis.