Fragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study
Background: Fragmented QRS (fQRS) results from myocardial scarring and predicts cardiovascular mortality and ventricular arrhythmia (VA). We evaluated the prevalence and prognostic value of fQRS in Asian patients hospitalized for heart failure.Methods and Results: This was a retrospective cohort stu...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:02a49ac7a3ab4344b587bd5e8628a6bb2021-11-11T05:58:40ZFragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study2297-055X10.3389/fcvm.2021.738417https://doaj.org/article/02a49ac7a3ab4344b587bd5e8628a6bb2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.738417/fullhttps://doaj.org/toc/2297-055XBackground: Fragmented QRS (fQRS) results from myocardial scarring and predicts cardiovascular mortality and ventricular arrhythmia (VA). We evaluated the prevalence and prognostic value of fQRS in Asian patients hospitalized for heart failure.Methods and Results: This was a retrospective cohort study of adult patients hospitalized for heart failure between 1st January 2010 and 31st December 2016 at a tertiary center in Hong Kong. The baseline ECG was analyzed. QRS complexes (<120 ms) with fragmented morphology in ≥2 contiguous leads were defined as fQRS. The primary outcome was a composite of cardiovascular mortality, VA, and sudden cardiac death (SCD). The secondary outcomes were the components of the primary outcome, myocardial infarction, and new-onset atrial fibrillation. In total, 2,182 patients were included, of whom 179 (8.20%) had fQRS. The follow-up duration was 5.63 ± 4.09 years. fQRS in any leads was associated with a higher risk of the primary outcome (adjusted hazard ratio (HR) 1.428 [1.097, 1.859], p = 0.001), but not myocardial infarction or new-onset atrial fibrillation. fQRS in >2 contiguous leads was an independent predictor of SCD (HR 2.679 [1.252, 5.729], p = 0.011). In patients without ischaemic heart disease (N = 1,396), fQRS in any leads remained predictive of VA and SCD (adjusted HR 3.526 [1.399, 8.887], p = 0.008, and 1.873 [1.103, 3.181], p = 0.020, respectively), but not cardiovascular mortality (adjusted HR 1.064 [0.671, 1.686], p = 0.792).Conclusion: fQRS is an independent predictor of cardiovascular mortality, VA, and SCD. Higher fQRS burden increased SCD risk. The implications of fQRS in heart failure patients without ischaemic heart disease require further studies.Jeffrey Shi Kai ChanJiandong ZhouJiandong ZhouSharen LeeAndrew LiAndrew LiMartin TanKeith Sai Kit LeungKeith Sai Kit LeungKamalan JeevaratnamTong LiuLeonardo RoeverYing LiuGary TseGary TseGary TseGary TseQingpeng ZhangFrontiers Media S.A.articlefragmented QRSheart failureAsianventricular arrhythmiasudden cardiac deathmyocardial fibrosisDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021) |
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fragmented QRS heart failure Asian ventricular arrhythmia sudden cardiac death myocardial fibrosis Diseases of the circulatory (Cardiovascular) system RC666-701 |
| spellingShingle |
fragmented QRS heart failure Asian ventricular arrhythmia sudden cardiac death myocardial fibrosis Diseases of the circulatory (Cardiovascular) system RC666-701 Jeffrey Shi Kai Chan Jiandong Zhou Jiandong Zhou Sharen Lee Andrew Li Andrew Li Martin Tan Keith Sai Kit Leung Keith Sai Kit Leung Kamalan Jeevaratnam Tong Liu Leonardo Roever Ying Liu Gary Tse Gary Tse Gary Tse Gary Tse Qingpeng Zhang Fragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study |
| description |
Background: Fragmented QRS (fQRS) results from myocardial scarring and predicts cardiovascular mortality and ventricular arrhythmia (VA). We evaluated the prevalence and prognostic value of fQRS in Asian patients hospitalized for heart failure.Methods and Results: This was a retrospective cohort study of adult patients hospitalized for heart failure between 1st January 2010 and 31st December 2016 at a tertiary center in Hong Kong. The baseline ECG was analyzed. QRS complexes (<120 ms) with fragmented morphology in ≥2 contiguous leads were defined as fQRS. The primary outcome was a composite of cardiovascular mortality, VA, and sudden cardiac death (SCD). The secondary outcomes were the components of the primary outcome, myocardial infarction, and new-onset atrial fibrillation. In total, 2,182 patients were included, of whom 179 (8.20%) had fQRS. The follow-up duration was 5.63 ± 4.09 years. fQRS in any leads was associated with a higher risk of the primary outcome (adjusted hazard ratio (HR) 1.428 [1.097, 1.859], p = 0.001), but not myocardial infarction or new-onset atrial fibrillation. fQRS in >2 contiguous leads was an independent predictor of SCD (HR 2.679 [1.252, 5.729], p = 0.011). In patients without ischaemic heart disease (N = 1,396), fQRS in any leads remained predictive of VA and SCD (adjusted HR 3.526 [1.399, 8.887], p = 0.008, and 1.873 [1.103, 3.181], p = 0.020, respectively), but not cardiovascular mortality (adjusted HR 1.064 [0.671, 1.686], p = 0.792).Conclusion: fQRS is an independent predictor of cardiovascular mortality, VA, and SCD. Higher fQRS burden increased SCD risk. The implications of fQRS in heart failure patients without ischaemic heart disease require further studies. |
| format |
article |
| author |
Jeffrey Shi Kai Chan Jiandong Zhou Jiandong Zhou Sharen Lee Andrew Li Andrew Li Martin Tan Keith Sai Kit Leung Keith Sai Kit Leung Kamalan Jeevaratnam Tong Liu Leonardo Roever Ying Liu Gary Tse Gary Tse Gary Tse Gary Tse Qingpeng Zhang |
| author_facet |
Jeffrey Shi Kai Chan Jiandong Zhou Jiandong Zhou Sharen Lee Andrew Li Andrew Li Martin Tan Keith Sai Kit Leung Keith Sai Kit Leung Kamalan Jeevaratnam Tong Liu Leonardo Roever Ying Liu Gary Tse Gary Tse Gary Tse Gary Tse Qingpeng Zhang |
| author_sort |
Jeffrey Shi Kai Chan |
| title |
Fragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study |
| title_short |
Fragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study |
| title_full |
Fragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study |
| title_fullStr |
Fragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study |
| title_full_unstemmed |
Fragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study |
| title_sort |
fragmented qrs is independently predictive of long-term adverse clinical outcomes in asian patients hospitalized for heart failure: a retrospective cohort study |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/02a49ac7a3ab4344b587bd5e8628a6bb |
| work_keys_str_mv |
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