Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging
Background: Fragmented QRS (FQRS) on surface electrocardiogram (ECG) is associated with the presence of myocardial scar tissue and may have prognostic value after certain ischemic events. We aimed to examine the anatomical correlation of FQRS with the presence of perfusion abnormalities in patients...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-12-01
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| Series: | Indian Heart Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483218302402 |
| _version_ | 1819094791748583424 |
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| author | Sepideh Hekmat Leili Pourafkari Mojan Ahmadi Mohammad Reza Chavoshi Bijan Zamani Nader D. Nader |
| author_facet | Sepideh Hekmat Leili Pourafkari Mojan Ahmadi Mohammad Reza Chavoshi Bijan Zamani Nader D. Nader |
| author_sort | Sepideh Hekmat |
| collection | DOAJ |
| description | Background: Fragmented QRS (FQRS) on surface electrocardiogram (ECG) is associated with the presence of myocardial scar tissue and may have prognostic value after certain ischemic events. We aimed to examine the anatomical correlation of FQRS with the presence of perfusion abnormalities in patients with suspected coronary artery disease (CAD). Methods: Patients without a known history of CAD, who were referred for myocardial perfusion imaging (MPI) between January 2016 and May 2016, were enrolled. The presence of FQRS on surface ECG was evaluated. The presence of FQRS, number of leads with FQRS, and the location of FQRS as well as patient characteristics were compared in patients with normal versus abnormal MPI. Multivariate model was constructed to identify independent factors associated with perfusion defect. Results: One hundred four women and 94 men were enrolled. Fragmentation of anterior, lateral, and inferior leads was detected in 13 (6.5%), 17 (8.5%), and 36 (18.1%) subjects, respectively. MPI was normal in 134 (67.6%) patients. FQRS was significantly more common in patients with abnormal MPI (p < 0.001). Age (odds ratio [OR]: 1.05 [1.02–1.08]; p = 0.001), number of the leads presenting FQRS (OR: 1.46 [1.12–1.92] p = 0.006), and diabetes (OR: 2.33 [1.16–4.69]; p = 0.018) were independent predictors of the presence of perfusion defect on MPI. Conclusion: In the absence of known CAD, FQRS is associated with the presence of perfusion abnormalities. Incorporating FQRS in diagnostic armamentarium may aid us in selecting patients who may benefit from MPI. Keywords: Electrocardiogram, Coronary artery disease, Myocardial perfusion imaging, Fragmented QRS |
| first_indexed | 2024-12-21T23:33:01Z |
| format | Article |
| id | doaj.art-6dfee05489634bd5915a0f7c71cc9d43 |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-21T23:33:01Z |
| publishDate | 2018-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-6dfee05489634bd5915a0f7c71cc9d432022-12-21T18:46:26ZengElsevierIndian Heart Journal0019-48322018-12-0170S177S181Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imagingSepideh Hekmat0Leili Pourafkari1Mojan Ahmadi2Mohammad Reza Chavoshi3Bijan Zamani4Nader D. Nader5Dept. of Nuclear Medicine, Iran University of Medical Sciences, Tehran, IranCardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Dept. of Anesthesiology, University at Buffalo, Buffalo, NY, USACardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, IranCardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, IranDept. of Cardiology, Ardabil University of Medical Sciences, Ardabil, IranDept. of Anesthesiology, University at Buffalo, Buffalo, NY, USA; Corresponding author. 77 Goodell Suite #550, Buffalo, NY, 14203, USA. Fax: +1 716 862 67 23.Background: Fragmented QRS (FQRS) on surface electrocardiogram (ECG) is associated with the presence of myocardial scar tissue and may have prognostic value after certain ischemic events. We aimed to examine the anatomical correlation of FQRS with the presence of perfusion abnormalities in patients with suspected coronary artery disease (CAD). Methods: Patients without a known history of CAD, who were referred for myocardial perfusion imaging (MPI) between January 2016 and May 2016, were enrolled. The presence of FQRS on surface ECG was evaluated. The presence of FQRS, number of leads with FQRS, and the location of FQRS as well as patient characteristics were compared in patients with normal versus abnormal MPI. Multivariate model was constructed to identify independent factors associated with perfusion defect. Results: One hundred four women and 94 men were enrolled. Fragmentation of anterior, lateral, and inferior leads was detected in 13 (6.5%), 17 (8.5%), and 36 (18.1%) subjects, respectively. MPI was normal in 134 (67.6%) patients. FQRS was significantly more common in patients with abnormal MPI (p < 0.001). Age (odds ratio [OR]: 1.05 [1.02–1.08]; p = 0.001), number of the leads presenting FQRS (OR: 1.46 [1.12–1.92] p = 0.006), and diabetes (OR: 2.33 [1.16–4.69]; p = 0.018) were independent predictors of the presence of perfusion defect on MPI. Conclusion: In the absence of known CAD, FQRS is associated with the presence of perfusion abnormalities. Incorporating FQRS in diagnostic armamentarium may aid us in selecting patients who may benefit from MPI. Keywords: Electrocardiogram, Coronary artery disease, Myocardial perfusion imaging, Fragmented QRShttp://www.sciencedirect.com/science/article/pii/S0019483218302402 |
| spellingShingle | Sepideh Hekmat Leili Pourafkari Mojan Ahmadi Mohammad Reza Chavoshi Bijan Zamani Nader D. Nader Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging Indian Heart Journal |
| title | Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging |
| title_full | Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging |
| title_fullStr | Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging |
| title_full_unstemmed | Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging |
| title_short | Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging |
| title_sort | fragmented qrs on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging |
| url | http://www.sciencedirect.com/science/article/pii/S0019483218302402 |
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