Key result
Fragmented QRS is linked to ~5-fold higher odds of a non-dipper BP pattern.
Why the study?
The relationship between blood pressure pattern and fragmented QRS on ECG has not been elucidated in normotensive patients with a history of preeclampsia.
Is fragmented QRS on ECG associated with a non-dipper blood pressure pattern in normotensive women with a history of preeclampsia?
Cross-Sectional (n=63)
The fQRS and echocardiographic measurements were blindly evaluated to prevent operator-induced bias without knowing the clinical status of the individuals.
No
Is fragmented QRS on ECG associated with a non-dipper blood pressure pattern in normotensive women with a history of preeclampsia?
Fragmented QRS on surface ECG independently predicts a non-dipper blood pressure pattern in normotensive women with prior preeclampsia and may help identify patients at elevated cardiovascular risk.
Answers are grounded in this paper and cite their sources.
Associated with non-dipper BP post-preeclampsia; leaves open prospective validation before clinical use.
Background/Aim: Hypertension is well defined in preeclamptic individuals and those with a history of preeclampsia. However, the relationship between blood pressure pattern and fragmented QRS on electrocardiography (ECG) has not been elucidated in normotensive patients with a history of preeclampsia. This study aimed to investigate the frequency of non-dipper blood pressure (BP) patterns in normotensive individuals with a history of preeclampsia and to evaluate the relevance of this pattern to fragmented QRS (fQRS). Methods: Sixty-three normotensive (office BP measurement) patients with a history of preeclampsia were included in this study between August 2020 and January 2021. These individuals underwent 24-hour ambulatory BP monitoring. The patients were divided into two groups as dipper and non-dipper, according to their BP patterns. The two groups were compared in terms of echocardiographic parameters, laboratory values, and QRS fragmentation on ECG. Results: Left ventricular diastolic dysfunction (LVDD) diagnosed by echocardiography ( P= 0.015) and fQRS on ECG ( P= 0.002) were significantly higher in the non-dipper group than in the dipper group. Tricuspid regurgitation velocity ( P= 0.004) and average E/e' ratio ( P< 0.001) were higher in the non-dipper group. Mitral E/A ratio ( P= 0.437) and left atrial volume index ( P= 0.439) were similar between the two groups in echocardiography. The fQRS, LVDD, triglyceride, and low-density lipoprotein were subjected to multivariate logistic regression analysis, and fQRS was found to be an independent predictor of the nondipper BP pattern in women with a history of preeclampsia ( P= 0.023, OR=4.951, 95% CI:1.245-19.688). Conclusion: The presence of an fQRS pattern on the ECG is associated with a non-dipper BP pattern in normotensive individuals with a history of preeclampsia.
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Göçer et al. (2021) conducted a cross-sectional in Normotensive women with a history of preeclampsia (n=63). Non-dipper blood pressure pattern (nighttime BP reduction <10% on 24-hour ABPM) vs. Dipper blood pressure pattern (nighttime BP reduction >10% on 24-hour ABPM) was evaluated on Fragmented QRS (fQRS) on 12-lead ECG and independent prediction of non-dipper BP pattern (OR 4.951, 95% CI 1.245-19.688, p=0.023). Fragmented QRS on ECG was significantly higher in the non-dipper group (44% vs 10.5%, P=0.002) and independently predicted a non-dipper BP pattern (OR 4.951, 95% CI 1.245-19.688, P=0.023).
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