Fragmented QRS was significantly associated with increased heart failure hospitalization in patients with hypertrophic cardiomyopathy (HR 5.4; 95% CI 1.2-36; P=0.03).
Cohort (n=94)
Does the presence of fragmented QRS predict heart failure progression and hospitalization in patients with hypertrophic cardiomyopathy?
Fragmented QRS on ECG is a significant independent predictor of heart failure hospitalization in patients with hypertrophic cardiomyopathy.
Effect estimate: HR 5.4 (95% CI 1.2-36)
Absolute Event Rate: 79% vs 95.1%
p-value: p=0.03
BACKGROUND: Although fragmented QRS complex (frag-QRS) reflecting intra-ventricular conduction delay has been shown to be a prognostic marker for cardiac events, few data exist regarding the impact of frag-QRS on cardiac events in hypertrophic cardiomyopathy (HCM). METHODS AND RESULTS: Ninety-four HCM patients (56 male; mean age, 58 ± 17 years) were retrospectively investigated. Frag-QRS was defined as the presence of various RsR' patterns in at least 2 contiguous ECG leads. Major arrhythmic events (MAE) were defined as sudden cardiac death, and combined sustained ventricular tachycardia/ventricular fibrillation. New-onset atrial fibrillation (AF) was diagnosed based on ECG during provisional or routine medical examination. Heart failure (HF) with hospitalization was defined as hospital admission due to subjective or objective symptoms. Frag-QRS was detected in 31 patients (33%).TNNI3 was the most frequent disease-causing gene. Median follow-up was 4.6 years. The 4-year cumulative survival rates of cardiac death, MAE, new-onset AF and HF with hospitalization were 97.6%, 94.6%, 87.5% and 89.3%, respectively. On multivariate analysis, frag-QRS was significantly associated with HF with hospitalization (adjusted hazard ratios 95% confidence intervals: 5.4 1.2-36, P=0.03). Moreover, HF-free survival was significantly lower in the frag-QRS (+) group compared to the frag-QRS (-) group (79.0% vs. 95.1%, P=0.03). CONCLUSIONS: Frag-QRS is associated with HF with hospitalization in HCM patients who had a unique distribution of gene mutations.
Nomura et al. (Wed,) conducted a cohort in Hypertrophic cardiomyopathy (n=94). Fragmented QRS vs. No fragmented QRS was evaluated on Heart failure-free survival (HR 5.4, 95% CI 1.2-36, p=0.03). Fragmented QRS was significantly associated with increased heart failure hospitalization in patients with hypertrophic cardiomyopathy (HR 5.4; 95% CI 1.2-36; P=0.03).