title: The prognostic significance of fragmented QRS in patients with left ventricular noncompaction cardiomyopathy.
abstract: BACKGROUND
  Fragmented QRS complexes (fQRS) were proven to be associated with the prognosis of several heart diseases. However, no data is available regarding fQRS in left ventricular noncompaction cardiomyopathy (LVNC), in which the outcome varies greatly and a simple yet practicable prognostic predictor is needed. The purpose of this study was to determine the prognostic value of fQRS in LVNC patients.
  
  
  METHODS
  Sixty-four LVNC patients were evaluated. Fragmented narrow QRS (f-nQRS) included single or multiple notches in the R or S wave in at least 2 contiguous electrocardiogram (ECG) leads and QRS duration < 120 ms, fragmented wide QRS (f-wQRS) included more than 2 notches and QRS duration > 120 ms.
  
  
  RESULTS
  f-nQRS and f-wQRS was present in 24 (38%) and 7 (11%) patients respectively. During follow-up, 13 patients died and 7 patients underwent heart transplantation. Kaplan-Meier analysis revealed that compared with the non-f-nQRS group, the f-nQRS group associated with a significantly lower survival (P = 0.005). The f-wQRS group also demonstrated a substantially lower survival as compared with the non-f-wQRS group (P = 0.02). Multivariate analysis indicated f-nQRS was an independent predictor of all-cause mortality (HR: 5.33; P = 0.045).
  
  
  CONCLUSIONS
  In LVNC patients, the presence of f-nQRS has significant prognostic value and may provide a valid method of risk stratification.
authors.affiliation: Cardiovascular Institute and FuWai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Ning
authors.forename: Min
authors.initials: M
authors.lastname: Tang
authors.forename: Ke-Ping
authors.initials: KP
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Hua
authors.forename: Ruo-Han
authors.initials: RH
authors.lastname: Chen
authors.forename: Jing
authors.initials: J
authors.lastname: Sha
authors.forename: Zhi-Min
authors.initials: ZM
authors.lastname: Liu
authors.forename: Shu
authors.initials: S
authors.lastname: Zhang
mesh_terms: D000328:Adult; D058406:Cardiac Resynchronization Therapy; D002423:Cause of Death; D017147:Defibrillators, Implantable; D004452:Echocardiography; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D004699:Endocardium / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012815:Signal Processing, Computer-Assisted