Original Article
The presence of fragmented QRS is associated with increased epicardial adipose tissue and subclinical myocardial dysfunction in healthy individuals
A presença de QRS fragmentados está associada ao aumento da espessura do tecido adiposo epicárdico e à disfunção miocárdica subclínica em indivíduos saudáveis
Mehmet Yamana,b,, , Ugur Arslana, Adil Bayramoglub, Osman Bektasb, Zeki Yuksel Gunaydinb, Ahmet Kayab
a University of Health Sciences, Samsun Training and Research Hospital, Samsun, Turkey
b Ordu University, Education and Research Hospital, Cardiology Department, Ordu, Turkey
Received 25 February 2017, Accepted 02 September 2017
Abstract
Aim

The aim of this study was to measure epicardial adipose tissue (EAT) and to assess left ventricular (LV) systolic and diastolic function in a healthy population grouped according to the presence of fragmented QRS (fQRS).

Methods

In this prospective case-control study, the study population consisted of 308 healthy individuals who were divided into two groups according to the existence of fQRS: 180 fQRS(+) individuals (with fQRS), and 128 age- and gender-matched fQRS(-) individuals (without fQRS). These individuals were assessed for EAT thickness and subclinical myocardial dysfunction using transthoracic echocardiography including strain imaging.

Results

The baseline clinical characteristics were similar between groups. EAT thickness was significantly increased in fQRS(+) individuals (0.59 vs. 0.44 mm, p<0.001). LV global longitudinal strain, reflecting systolic function (19.62±3.05 vs. 20.95±2.36, p<0.001) and E/A ratio, reflecting diastolic function (0.95±0.30 vs. 1.10±0.37, p<0.001), were decreased, revealing subclinical myocardial dysfunction, in fQRS(+) individuals.

Conclusions

The presence of fQRS on the admission ECG is associated with increased EAT and pronounced subclinical LV systolic and diastolic dysfunction in a healthy population. Further studies with larger patient groups are needed to clarify the exact pathophysiological mechanisms underlying these findings in healthy populations.

Resumo
Objetivo

Medir o tecido adiposo epicárdico (EAT) e avaliar as funções sistólica e diastólica do ventrículo esquerdo (VE) numa população saudável segundo a presença de QRS fragmentados (fQRS).

Métodos

Neste estudo caso-controle prospetivo participaram 308 indivíduos saudáveis. A amostra foi dividida em dois grupos de acordo com a existência de fQRS; 180 fQRS (+) versus 128 fQRS (-) emparelhados por idade e sexo. Os indivíduos foram avaliados segundo a espessura do EAT e a disfunção miocárdica subclínica por ecocardiografia transtorácica, inclusive imagens de deformação miocárdica (strain).

Resultados

As características clínicas basais foram semelhantes entre os grupos. A espessura do EAT estava significativamente aumentada nos indivíduos fQRS (+) (0,59 versus 0,44 mm, p<0,001). A deformação longitudinal global do VE que caracterizou a função sistólica (19,62±3,05 versus 20,95±2,36, p<0,001) e a relação E/A, um parâmetro da função diastólica (0,95±0,30 versus 1,10±0,37, p<0,001), estavam diminuídas e traduziram disfunção miocárdica subclínica no grupo de indivíduos fQRS (+).

Conclusões

A presença no eletrocardiograma de admissão de QRS fragmentados está associada ao aumento do tecido adiposo epicárdico e à disfunção sistólica e diastólica subclínica do ventrículo esquerdo na população saudável. Para caracterizar os mecanismos fisiopatológicos subjacentes a esses factos numa população saudável são necessários outros estudos com grupos de participantes mais numerosos.

Keywords
Fragmented QRS, Epicardial adipose tissue, Myocardial dysfunction, Healthy
Palavras-chave
QRS fragmentados, Tecido adiposo epicárdico, Disfunção miocárdica, Saudável

Metrics

  • Impact Factor: 0.827(2017)
  • 5-years Impact Factor: 0,775
  • SCImago Journal Rank (SJR):0,267
  • Source Normalized Impact per Paper (SNIP):0,419