Muzaffer KAYHAOĞLU, Çetin GEÇMEN, Mehmet ÇELİK, Emrah BAYRAM, Ender Özgün ÇAKMAK, Cevat KIRMA, Yusuf YILMAZ, Özkan CANDAN, İbrahim Akın İZGİ

Fragmente QRS, Hipertansiyonlu Hastalarda Subklinik Sol Ventrikül Disfonksiyonu ile İlişkili Olabilir

Giriş: Hipertansif hastalarda, subklinik sol ventrikül disfonksiyonunun erken tespiti, agresif risk faktörü kontrolü ve tıbbi tedavi ile hastaların kalp yetmezliğini önleyebilir veya geciktirebilir. Fragmente QRS (fQRS), miyokardiyal fibrozisin bir belirtecidir ve miyokardiyal fibrozis, hipertansif hastalarda sol ventrikül disfonksiyonuna neden olur. Bu çalışmada, hipertansif hastalarda fQRS varlığı ile sol ventrikül fonksiyonu arasındaki ilişkiyi benek takip ekokardiyografi yöntemi ile değerlendirmek amaçlanmıştır. Hastalar ve Yöntem: Çalışmaya toplam 95 hipertansif hasta dahil edilmiştir. Tüm hastalara ayrıntılı anamnez, fizik muayene ve laboratuvar testleri yapılmış, 12 derivasyonlu elektrokardiyografi çekilmiş ve konvansiyonel ekokardiyografi yapılmıştır. Katılan hastalar fQRS (+) (n= 33) ve fQRS (-) (n= 62) olarak iki gruba ayrılmıştır. Bulgular: fQRS (-) grubuyla karşılaştırıldığında, fQRS (+) grubu daha yaşlı, ortalama hipertansiyon süresi daha uzun ve daha yüksek hemoglobin düzeyine sahip bulunmuştur. fQRS (+) grubunda interventriküler septum kalınlığı, arka duvar kalınlığı, sol ventriküler kitle indeksi, rölatif duvar kalınlığı, deselerasyon zamanı ve E/Em parametreleri anlamlı olarak yüksek iken, sol ventriküler global longitudinal strain değerleri fQRS (-) grubuna göre anlamlı olarak daha düşük tespit edilmiştir. Çoklu doğrusal regresyon analizi sonucunda, fQRS varlığı ve hipertansiyon süresi, sol ventriküler global longitudinal strain için bağımsız prediktörler olarak tanımlanmıştır. Sonuç: Bu çalışmada, miyokardiyal fibrozise sekonder gelişen subklinik sol ventrikül disfonksiyonunun, 12 derivasyonlu elektrokardiyografide basit bir belirteç olan fQRS ile tahmin edilebileceğini göstermiştir.

Fragmented QRS May Be Associated with Subclinical Left Ventricular Dysfunction in Patients with Hypertension

Introduction: In hypertensive patients, the early detection of subclinical left ventricular dysfunction could prevent or delay patients from heart failure by aggressive risk factor control and rigorous medical management. Fragmented QRS (fQRS) is a marker of myocardial fibrosis, and myocardial fibrosis causes left ventricular dysfunction in hypertensive patients. In this study, we aimed to assess the association between the presence of fQRS and LV function at hypertensive patients using the speckle tracking echocardiography method. Patients and Methods: The study included a total of 95 hypertensive patients. Detailed anamnesis, physical examination, laboratory tests, 12-lead electrocardiography, and conventional echocardiography were administered to all patients. The participating patients were divided into two groups as fQRS (+) (n= 33) and fQRS (-) (n= 62). Results: Compared to the fQRS (-) group, the fQRS (+) group had older age, the average duration of hypertension was longer, and had a higher hemoglobin level. In the fQRS (+) group, interventricular septum thickness, posterior wall thickness, left ventricular mass index, relative wall thickness, deceleration time, and E/Em were significantly higher while left ventricular global longitudinal strain values were lower compared to fQRS (-) group. In the multiple linear regression analysis, fQRS and duration of hypertension were identified as independent predictors of LV-GLS. Conclusion: In this study, we demonstrated that subclinical left ventricular dysfunction developing secondary to myocardial fibrosis could be predicted by fQRS, a simple marker in 12-lead electrocardiography..

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi