Author + information
- Ersin Yıldırım,
- Denizhan Karaçimen,
- Ceyhan Türkkan,
- Damirbek Osmonov,
- Kazım Serhan Özcan,
- Servet Altay,
- Ufuk Sadık Ceylan,
- Murat Uğur,
- Mehmet Bozbay and
- İzzet Erdinler
Fragmented QRS (fQRS) developed by intraventricular depolarization and signal conduction disturbance due to myocardial ischemia, scar or fibrosis. In the literature, some of the studies showed negative correlation between left ventricular ejection fraction (LVEF) and fQRS. Current study, aimed to evaluate if there is relationship between number of fQRS derivations and LVEF.
Between 2010-2012 years, 335 consecutive patients admitted to coronary care unit of our hospital with acute ST-elevated myocardial infarction (STEMI) were included in study population. Electrocardiographic and echocardiographic properties of these patients were evaluated prospectively.
Two hundred and seventy of the patients were male (80%). QRS fragmented and non fQRS group had 217 (65%) and 118 (35%) patients, respectively. Mean age of the patients was 58±12 years. 222 (66%) patients were smoker, 9 (3%) patient was alcohol consumer, 144 patient (42%) had hypertension, 73 patient (21%) had diabetes mellitus, 6 patient (1.7%) had chronic renal failure, 25 patient (7.4%) had hyperlipidemia or using antihyperlipidemic drugs. QRS fragmented group had statistically significant low LVEF compared to non fQRS group (Table-1). Also, the number of fQRS derivations were associated with lower LVEF. Statistically significant negative correlation between increased number of fragmented QRS derivations and LVEF was detected(r=-0.379, p=<0.001) (Table-2).
Echocardiographic evaluation in acute STEMI patients showed that fQRS group had lower ejection fraction values which had statistically significant negative relationship between increased fragmented derivation number and ejection fraction. Presence and number of fQRS derivations in acute ST-elevated myocardial infarction was associated with expansion of infarction. At cellular level, this may be the effect of the myocardial ischemia or scar on myocardial electrical parameters.
|Ejection fraction (%)||50.21±10.47 (50)||41.66±11.45 (40)||0.001**|
|Left ventricular systolic diameter||3.19±0.59 (3.2)||3.67±0.79 (3.6)||0.001**|
|Left ventricular diastolic diameter||4.87±0.42 (4.9)||5.17±0.61 (5.2)||0.001**|
Student t Test, ++Mann Whitney UTest **p<0.01
|Number of fragmented Derivations||0||2||3||≥4|
One Way Anova Test **p<0.01