, Hamdi Pusuroğlu 2
, Muammer Karakayalı 3
, Anıl Şahin 4
, Ali Rıza Demir 3
, Emre Yılmaz 3
, Ahmet Yasar Cizgici 3
, Mehmet Erturk 3
2University of Health Sciences, Başakşehir Cam and Sakura Hospital, İstanbul, Turkey
3Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
4Department of Cardiology, Faculty of Medicine, İstinye University, Liv Bahçeşehir Hospital, İstanbul, Turkey
Abstract
Background: In patients with essential hypertension, fragmented QRS has been associated with many remodeling components that might lead to adverse cardiovascular effects. This study aimed to evaluate the relationship between fragmented QRS and adverse events and its potential long-term prognostic value.
Methods: The patients with essential hypertension were divided into two groups accord-
ing to the presence of fragmented QRS: fragmented QRS (+) and fragmented QRS (−). During long-term follow-up, the relationship of fragmented QRS to coronary artery dis-ease, congestive heart failure, stroke, cardiovascular death, all-cause death, and major adverse cardiovascular and cerebrovascular events was evaluated.
Results: The study group included 542 patients with essential hypertension. Fragmented QRS on ECG was observed in 224 (41.3%) patients. Considering the incidence rates at the
end of 5.6 ± 1.3 years’ follow-up, the total incidence rate of major adverse cardiovascular and cerebrovascular events (P <.001), coronary artery disease (P <.001), and congestive heart failure (P <.001) were higher in patients with fragmented QRS. No significant difference was observed between the two groups in terms of stroke (P =.734), cardiovascular death (P = 1), and all-cause death (P =.574). As a result of multiple cox regression analysis, fragmented QRS (P =.005) was identified as an independent predictor for major adverse cardiovascular and cerebrovascular events development.
Conclusion: In patients with hypertension, the presence of fragmented QRS was found as an independent predictor for major adverse cardiovascular and cerebrovascular events development.