Key result
Fragmented QRS on ECG detects myocardial fibrosis with ~84% sensitivity.
Why the study?
The study was conducted to analyze the relationship between fQRS and myocardial fibrosis in CAD patients using SPECT.
Does the presence of a fragmented QRS (fQRS) complex on ECG accurately detect myocardial fibrosis in patients with suspected coronary artery disease?
Observational (n=116)
Does the presence of a fragmented QRS (fQRS) complex on ECG accurately detect myocardial fibrosis in patients with suspected coronary artery disease?
The fragmented QRS complex is a sensitive and informative electrocardiographic marker for detecting myocardial scarring in patients with suspected coronary artery disease.
Answers are grounded in this paper and cite their sources.
fQRS may aid fibrosis detection on ECG but should not yet change practice; hypothesis-generating for validation against imaging in CAD.
Aim– to analyze the relationship between fQRS and myocardial fibrosis in CAD patients using SPECT. Material and methods.Retrospectively, we have analyzed the anamnesis and examinations of 116 patients with suspected coronary heart disease. The fQRS was assessed according to the criteria of Das M. et al., 2006, along with the presence of a pathological Q wave and a slow increase in the amplitude of the R wave. We analysed the transient myocardial ischemia and/or myocardial scarring using stress/rest SPECT with technetium-99m. Results.fQRS was significantly more frequently detected in patients with stable and partially reversible perfusion defects – 44.1% and 52.2%, respectively, versus 13.0% and 5.5% in patients without perfusion defects or with reversible perfusion defects, p 0.05. Among 28 patients with QRS fragmentation and myocardial fibrosis, 19 (67.8%) had classical signs of fibrosis on the ECG, 9 (32.1%) had no ECG-registered fibrosis but fQRS was detected. The sensitivity of fQRS marker in detecting myocardial fibrosis reached 84.4%, the specificity was 63.3%. Conclusion.fQRS complex is an informative marker for detecting myocardial scarring in patients with coronary artery disease. Analysis of fQRS in daily clinical practice may increase the diagnostic value of electrocardiography in the detection of fibrosis.
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Gordeeva et al. (2022) conducted an observational in Suspected coronary heart disease (n=116). Fragmented QRS (fQRS) assessment vs. Absence of fQRS was evaluated on Presence of stable perfusion defects (myocardial fibrosis) on SPECT (p=0.05). Fragmented QRS on ECG was significantly more frequent in patients with stable myocardial perfusion defects (44.1% vs 13.0%), showing 84.4% sensitivity and 63.3% specificity for myocardial fibrosis.
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