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Article: Fragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study

TitleFragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study
Authors
KeywordsAsian
fragmented QRS
heart failure
myocardial fibrosis
sudden cardiac death
ventricular arrhythmia
Issue Date2021
Citation
Frontiers in Cardiovascular Medicine, 2021, v. 8, article no. 738417 How to Cite?
AbstractBackground: 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.
Persistent Identifierhttp://hdl.handle.net/10722/336866
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, Jeffrey Shi Kai-
dc.contributor.authorZhou, Jiandong-
dc.contributor.authorLee, Sharen-
dc.contributor.authorLi, Andrew-
dc.contributor.authorTan, Martin-
dc.contributor.authorLeung, Keith Sai Kit-
dc.contributor.authorJeevaratnam, Kamalan-
dc.contributor.authorLiu, Tong-
dc.contributor.authorRoever, Leonardo-
dc.contributor.authorLiu, Ying-
dc.contributor.authorTse, Gary-
dc.contributor.authorZhang, Qingpeng-
dc.date.accessioned2024-02-29T06:57:04Z-
dc.date.available2024-02-29T06:57:04Z-
dc.date.issued2021-
dc.identifier.citationFrontiers in Cardiovascular Medicine, 2021, v. 8, article no. 738417-
dc.identifier.urihttp://hdl.handle.net/10722/336866-
dc.description.abstractBackground: 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.-
dc.languageeng-
dc.relation.ispartofFrontiers in Cardiovascular Medicine-
dc.subjectAsian-
dc.subjectfragmented QRS-
dc.subjectheart failure-
dc.subjectmyocardial fibrosis-
dc.subjectsudden cardiac death-
dc.subjectventricular arrhythmia-
dc.titleFragmented QRS Is Independently Predictive of Long-Term Adverse Clinical Outcomes in Asian Patients Hospitalized for Heart Failure: A Retrospective Cohort Study-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.3389/fcvm.2021.738417-
dc.identifier.scopuseid_2-s2.0-85134142382-
dc.identifier.volume8-
dc.identifier.spagearticle no. 738417-
dc.identifier.epagearticle no. 738417-
dc.identifier.eissn2297-055X-
dc.identifier.isiWOS:000727860600001-

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