Fragmented QRS Complexes Are Associated with Cardiac Fibrosis and Significant Intraventricular Systolic Dyssynchrony in Nonischemic Dilated Cardiomyopathy Patients with a Narrow QRS Interval

Background: Myocardial scar causes heterogeneous ventricular activation, which results in fragmentation of QRS complexes on ECG. Myocardial fibrosis in patients with nonischemic cardiomyopathy (NDCM) can be identified as late gadolinium enhancement (LGE) areas on cardiac magnetic resonance (CMR) stu...

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Veröffentlicht in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2011-01, Vol.28 (1), p.62-68
Hauptverfasser: Basaran, Yelda, Tigen, Kursat, Karaahmet, Tansu, Isiklar, Iclal, Cevik, Cihan, Gurel, Emre, Dundar, Cihan, Pala, Selcuk, Mahmutyazicioglu, Kamran, Basaran, Ozcan
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container_issue 1
container_start_page 62
container_title Echocardiography (Mount Kisco, N.Y.)
container_volume 28
creator Basaran, Yelda
Tigen, Kursat
Karaahmet, Tansu
Isiklar, Iclal
Cevik, Cihan
Gurel, Emre
Dundar, Cihan
Pala, Selcuk
Mahmutyazicioglu, Kamran
Basaran, Ozcan
description Background: Myocardial scar causes heterogeneous ventricular activation, which results in fragmentation of QRS complexes on ECG. Myocardial fibrosis in patients with nonischemic cardiomyopathy (NDCM) can be identified as late gadolinium enhancement (LGE) areas on cardiac magnetic resonance (CMR) studies. We investigated the association of fragmented QRS (fQRS) complexes with systolic dyssynchrony and myocardial fibrosis in patients with NDCM. Methods: Twenty patients with NDCM and sinus rhythm who had fQRS complexes were evaluated with CMR. The association of fQRS complexes with LGE and systolic dyssynchrony was investigated. Results: Nineteen patients had significant systolic dyssynchrony with echocardiography. Among 19 patients with significant dyssynchrony, 14 (74%) patients had fQRS complexes in the most delayed contracting segment or one of the dyssynchronous segments, whereas five patients (26%) had fQRS complexes in a lead which is discordant with the dyssynchronous segment on echocardiography. Seventeen patients had LGE in their CMR. Among the 17 patients with LGE; 13 patients (76%) had fQRS complexes concordant with LGE present segments. Conclusion: Fragmentation of QRS complexes on ECG is associated with intraventricular systolic dyssynchrony and subendocardial fibrosis in NDCM patients with a narrow QRS interval and sinus rhythm. (Echocardiography 2011;28:62‐68)
doi_str_mv 10.1111/j.1540-8175.2010.01242.x
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Myocardial fibrosis in patients with nonischemic cardiomyopathy (NDCM) can be identified as late gadolinium enhancement (LGE) areas on cardiac magnetic resonance (CMR) studies. We investigated the association of fragmented QRS (fQRS) complexes with systolic dyssynchrony and myocardial fibrosis in patients with NDCM. Methods: Twenty patients with NDCM and sinus rhythm who had fQRS complexes were evaluated with CMR. The association of fQRS complexes with LGE and systolic dyssynchrony was investigated. Results: Nineteen patients had significant systolic dyssynchrony with echocardiography. Among 19 patients with significant dyssynchrony, 14 (74%) patients had fQRS complexes in the most delayed contracting segment or one of the dyssynchronous segments, whereas five patients (26%) had fQRS complexes in a lead which is discordant with the dyssynchronous segment on echocardiography. Seventeen patients had LGE in their CMR. Among the 17 patients with LGE; 13 patients (76%) had fQRS complexes concordant with LGE present segments. Conclusion: Fragmentation of QRS complexes on ECG is associated with intraventricular systolic dyssynchrony and subendocardial fibrosis in NDCM patients with a narrow QRS interval and sinus rhythm. 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Myocardial fibrosis in patients with nonischemic cardiomyopathy (NDCM) can be identified as late gadolinium enhancement (LGE) areas on cardiac magnetic resonance (CMR) studies. We investigated the association of fragmented QRS (fQRS) complexes with systolic dyssynchrony and myocardial fibrosis in patients with NDCM. Methods: Twenty patients with NDCM and sinus rhythm who had fQRS complexes were evaluated with CMR. The association of fQRS complexes with LGE and systolic dyssynchrony was investigated. Results: Nineteen patients had significant systolic dyssynchrony with echocardiography. Among 19 patients with significant dyssynchrony, 14 (74%) patients had fQRS complexes in the most delayed contracting segment or one of the dyssynchronous segments, whereas five patients (26%) had fQRS complexes in a lead which is discordant with the dyssynchronous segment on echocardiography. Seventeen patients had LGE in their CMR. Among the 17 patients with LGE; 13 patients (76%) had fQRS complexes concordant with LGE present segments. Conclusion: Fragmentation of QRS complexes on ECG is associated with intraventricular systolic dyssynchrony and subendocardial fibrosis in NDCM patients with a narrow QRS interval and sinus rhythm. (Echocardiography 2011;28:62‐68)</description><subject>Adult</subject><subject>cardiac fibrosis</subject><subject>Cardiomyopathy, Dilated - diagnosis</subject><subject>Cardiomyopathy, Dilated - diagnostic imaging</subject><subject>Diagnosis, Differential</subject><subject>Echocardiography - methods</subject><subject>Endomyocardial Fibrosis - diagnostic imaging</subject><subject>Endomyocardial Fibrosis - physiopathology</subject><subject>Female</subject><subject>fQRS complex</subject><subject>Humans</subject><subject>Ischemia - diagnosis</subject><subject>Ischemia - diagnostic imaging</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>nonischemic cardiomyopathy</subject><subject>Radiography</subject><subject>Ventricular Dysfunction - diagnosis</subject><subject>Ventricular Dysfunction - diagnostic imaging</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kc1OGzEUha2qVQmUV6i862pS_87PplI0JYCgoSUIlpbj8RCnM3ZqT0jm5Xg2PAmNN7buOf7u1T0AQIzGOJ7vqzHmDCU5zviYoFhFmDAy3n0Ao6PwEYxQxkhCckJOwGkIK4RQhjH7DE4ISnFOCzQCr1Mvn1ttO13BP_dzWLp23eidDnDiNZyE4JSRg7g13RKW0ldGKjg1C--CCVDaCs7NszW1UdJ28Np2Xr5EnDdq00gP533oXGMU_NmH0Fu19M720Fg4c9YEtdTtoJlm32OPd23v1rJb9vC37ExEhUNvCWfSe7fdjxn7aP8imy_gUy2boM_f7zPwML14KK-S27vL63JymyjKc5LwBeWkSKmuKsLTHKOU1VXBC0RTpvKiVjyrMqYpw0pypaKDSEoqQlOEeM3oGfh2wK69-7fRoRNtHF43jbTabYLIWUbyNC40Or--OzeLVldi7U0rfS_-bzwafhwMW9Po_qhjJIZkxUoMAYohQDEkK_bJip24KK_uhmcEJAeACZ3eHQHS_xVpRuO3p9mleMK_0uns_kY80jdr3qlk</recordid><startdate>201101</startdate><enddate>201101</enddate><creator>Basaran, Yelda</creator><creator>Tigen, Kursat</creator><creator>Karaahmet, Tansu</creator><creator>Isiklar, Iclal</creator><creator>Cevik, Cihan</creator><creator>Gurel, Emre</creator><creator>Dundar, Cihan</creator><creator>Pala, Selcuk</creator><creator>Mahmutyazicioglu, Kamran</creator><creator>Basaran, Ozcan</creator><general>Blackwell Publishing Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201101</creationdate><title>Fragmented QRS Complexes Are Associated with Cardiac Fibrosis and Significant Intraventricular Systolic Dyssynchrony in Nonischemic Dilated Cardiomyopathy Patients with a Narrow QRS Interval</title><author>Basaran, Yelda ; Tigen, Kursat ; Karaahmet, Tansu ; Isiklar, Iclal ; Cevik, Cihan ; Gurel, Emre ; Dundar, Cihan ; Pala, Selcuk ; Mahmutyazicioglu, Kamran ; Basaran, Ozcan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3582-5b352963edd25681064fd9590364c89fc57d74e341ca5cc6812a32d236005f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>cardiac fibrosis</topic><topic>Cardiomyopathy, Dilated - diagnosis</topic><topic>Cardiomyopathy, Dilated - diagnostic imaging</topic><topic>Diagnosis, Differential</topic><topic>Echocardiography - methods</topic><topic>Endomyocardial Fibrosis - diagnostic imaging</topic><topic>Endomyocardial Fibrosis - physiopathology</topic><topic>Female</topic><topic>fQRS complex</topic><topic>Humans</topic><topic>Ischemia - diagnosis</topic><topic>Ischemia - diagnostic imaging</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>nonischemic cardiomyopathy</topic><topic>Radiography</topic><topic>Ventricular Dysfunction - diagnosis</topic><topic>Ventricular Dysfunction - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Basaran, Yelda</creatorcontrib><creatorcontrib>Tigen, Kursat</creatorcontrib><creatorcontrib>Karaahmet, Tansu</creatorcontrib><creatorcontrib>Isiklar, Iclal</creatorcontrib><creatorcontrib>Cevik, Cihan</creatorcontrib><creatorcontrib>Gurel, Emre</creatorcontrib><creatorcontrib>Dundar, Cihan</creatorcontrib><creatorcontrib>Pala, Selcuk</creatorcontrib><creatorcontrib>Mahmutyazicioglu, Kamran</creatorcontrib><creatorcontrib>Basaran, Ozcan</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Basaran, Yelda</au><au>Tigen, Kursat</au><au>Karaahmet, Tansu</au><au>Isiklar, Iclal</au><au>Cevik, Cihan</au><au>Gurel, Emre</au><au>Dundar, Cihan</au><au>Pala, Selcuk</au><au>Mahmutyazicioglu, Kamran</au><au>Basaran, Ozcan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fragmented QRS Complexes Are Associated with Cardiac Fibrosis and Significant Intraventricular Systolic Dyssynchrony in Nonischemic Dilated Cardiomyopathy Patients with a Narrow QRS Interval</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2011-01</date><risdate>2011</risdate><volume>28</volume><issue>1</issue><spage>62</spage><epage>68</epage><pages>62-68</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract>Background: Myocardial scar causes heterogeneous ventricular activation, which results in fragmentation of QRS complexes on ECG. Myocardial fibrosis in patients with nonischemic cardiomyopathy (NDCM) can be identified as late gadolinium enhancement (LGE) areas on cardiac magnetic resonance (CMR) studies. We investigated the association of fragmented QRS (fQRS) complexes with systolic dyssynchrony and myocardial fibrosis in patients with NDCM. Methods: Twenty patients with NDCM and sinus rhythm who had fQRS complexes were evaluated with CMR. The association of fQRS complexes with LGE and systolic dyssynchrony was investigated. Results: Nineteen patients had significant systolic dyssynchrony with echocardiography. Among 19 patients with significant dyssynchrony, 14 (74%) patients had fQRS complexes in the most delayed contracting segment or one of the dyssynchronous segments, whereas five patients (26%) had fQRS complexes in a lead which is discordant with the dyssynchronous segment on echocardiography. Seventeen patients had LGE in their CMR. Among the 17 patients with LGE; 13 patients (76%) had fQRS complexes concordant with LGE present segments. Conclusion: Fragmentation of QRS complexes on ECG is associated with intraventricular systolic dyssynchrony and subendocardial fibrosis in NDCM patients with a narrow QRS interval and sinus rhythm. (Echocardiography 2011;28:62‐68)</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>20618390</pmid><doi>10.1111/j.1540-8175.2010.01242.x</doi><tpages>7</tpages></addata></record>
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subjects Adult
cardiac fibrosis
Cardiomyopathy, Dilated - diagnosis
Cardiomyopathy, Dilated - diagnostic imaging
Diagnosis, Differential
Echocardiography - methods
Endomyocardial Fibrosis - diagnostic imaging
Endomyocardial Fibrosis - physiopathology
Female
fQRS complex
Humans
Ischemia - diagnosis
Ischemia - diagnostic imaging
Magnetic Resonance Angiography
Male
nonischemic cardiomyopathy
Radiography
Ventricular Dysfunction - diagnosis
Ventricular Dysfunction - diagnostic imaging
title Fragmented QRS Complexes Are Associated with Cardiac Fibrosis and Significant Intraventricular Systolic Dyssynchrony in Nonischemic Dilated Cardiomyopathy Patients with a Narrow QRS Interval
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