Key result
The presence of fragmented QRS in patients with diabetes mellitus was independently associated with complex ventricular arrhythmias.
Why the study?
Ventricular arrhythmias are frequent in diabetes mellitus, and fragmented QRS on ECG is a marker of myocardial fibrosis, but its association with complex ventricular arrhythmias in diabetes was unknown.
Is the presence of fragmented QRS on ECG associated with complex ventricular arrhythmias in patients with type-2 diabetes mellitus?
Observational (n=611)
Is the presence of fragmented QRS on ECG associated with complex ventricular arrhythmias in patients with type-2 diabetes mellitus?
Fragmented QRS on ECG is independently associated with complex ventricular arrhythmias in patients with type-2 diabetes mellitus, suggesting its potential utility as a non-invasive risk stratification marker.
Answers are grounded in this paper and cite their sources.
fQRS may signal elevated complex VA risk in DM; hypothesis-generating and should not yet alter practice or risk models.
Background Ventricular arrhythmias (VAs) are frequent in diabetes mellitus (DM) patients. Myocardial fibrosis is one of the components of diabetic cardiomyopathy secondary to DM. Fragmented QRS (fQRS) on electrocardiography (ECG) has been shown to be a marker of myocardial fibrosis. In this study, we aimed to investigate the association between fQRS and complex VAs in patients with DM.Methods Three hundred and thirty-six consecutive patients who were diagnosed with DM were included in the study. The control group consisted of 275 age- and sex-matched healthy individuals. ECG and transthoracic echocardiography were performed in all the patients. fQRS was defined as additional R’ wave or notching/splitting of S wave in two contiguous ECG leads. All the patients underwent 24-h Holter monitoring and VAs were classified using Lown’s scoring system. Lown class ≥ 3 VAs were considered as complex VAs.Results As compared to the healthy individuals, prevalence of fQRS (37.5% vs. 6.9%, p < .001) and complex VAs (14% vs. 0%, p < .001) were significantly higher in patients with DM. Furthermore, complex VAs (28.4% vs. 6.4%, p < .001) were significantly higher in DM patients with fQRS. In multiple logistic regression analysis, DM duration (OR: 1.510, 95% CI:1.343 to 1.698; p < .001) and presence of fQRS (OR: 3.262, 95% CI: 1.443 to 7.376; p = .004) were independent predictors for complex VAs.Conclusions The presence of fQRS may be associated with complex VAs in patients with DM. Therefore, fQRS may be used as a predictor of complex VAs and the risk of sudden death in patients with DM.
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Eren et al. (2019) conducted an observational in Type-2 diabetes mellitus (n=611). Fragmented QRS vs. Absence of fragmented QRS was evaluated on Complex ventricular arrhythmias (Lown class ≥ 3) (OR 3.262, 95% CI 1.443-7.376, p=0.004). The presence of fragmented QRS in patients with diabetes mellitus was independently associated with complex ventricular arrhythmias.
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