The Relationship Between Fragmented QRS and Diastolic Parameters in Coronary Artery Disease Patients with Noncritical Lesions
Ferdi Sezer1, Murat Meric1, Serkan Yuksel1, Murat Akcay1, Okan Gulel11Department Of Cardiology, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
Background: Previous studies have shown fragmented QRS (fQRS) in electrocardiography (ECG) to be associated with regional myocardial scars. We sought in this study to evaluate the effect of fQRS on diastolic parameters using conventional and tissue Doppler methods in patients with normal systolic function who have noncritical stenosis demonstrated via coronary angiography. Method: This study includes 60 patients with fQRS on a surface ECG and 40 control patients with similar demographic characteristics but without fQRS on a surface ECG. Diastolic parameters were compared between the two groups using the conventional and tissue Doppler methods. Fragmented QRS was defined as the presence of a second R (R’) wave, notching of the R or S wave, or fragmentation of the R wave (more than one R’) in at least two consecutive leads compatible with epicardial coronary arteries. Result: Compared with conventional echocardiography, regional tissue Doppler parameters revealed significant differences in patients with fQRS compared to those without fQRS: e’ (tissue Doppler early diastolic velocity) and e’/a’ (the ratio of early to late diastolic velocities) from tissue Doppler echocardiography parameters were found to be lower in patients with fQRS compared with the control group (p < 0.05). Conclusýon: According to the results of our study, the presence of fQRS on a surface ECG is associated with deterioration of left ventricular diastolic function, both regionally and globally, and this deterioration is more evident at the tissue level. In conclusion, fQRS on a surface ECG can be an early predictor of diastolic dysfunction.
Cite This Article
Sezer F, Meric M, Yuksel S, Akcay M, Gulel O. The Relationship Between Fragmented QRS and Diastolic Parameters in Coronary Artery Disease Patients with Noncritical Lesions. EJMI. 2018; 2(4): 213-219
Corresponding Author: Murat Meric