title: Comparison of fragmented QRS and myocardial perfusion-gated SPECT findings.
abstract: OBJECTIVE
  Fragmented QRS (fQRS) complex is an ECG parameter that has recently been introduced and investigated. It is assumed that fQRS occurs because of disruptions in ventricular conduction due to ventricular infarction and ischemia. Therefore, in this article, we aimed to investigate the relationship between the detection of infarction and ischemia on myocardial perfusion-gated single-photon emission computed tomography images and appearance of fQRS on ECG.
  
  
  METHODS
  We retrospectively reviewed the records of patients with a diagnosis of coronary artery disease who were referred to our institution for myocardial perfusion scintigraphy. In total, 261 patients (122 women and 139 men, with a mean age of 61±10.33 years) with and without fQRS (136 and 125, respectively) were included in the present study. The myocardial perfusion scintigraphy results were evaluated for the presence or absence of myocardial ischemia and infarction by visual and quantitative (summed stress score, summed rest, summed difference score, summed motion score, and summed thickening score) assessments. Statistical analysis was performed to determine the relationship between the presence of fQRS and myocardial ischemia and/or infarction. Student's t-test and the Mann-Whitney U-test were used for comparing the results. Pearson's χ2-test and Fisher's exact tests were also used to compare the distribution of variables between the two groups.
  
  
  RESULTS
  The prevalence of ischemia and infarction were found to be, respectively, 4.38-fold and 5.95-fold higher in patients with fQRS compared with the control group. Moreover, the prevalence of both ischemia and infarction was found to be 10.54-fold higher in patients with fQRS compared with the control group.
  
  
  CONCLUSIONS
  There is a highly statistically significant possibility of detecting ischemia and infarction in perfusion myocardial scintigrams of patients whose ECGs have fQRS.
authors: Departments of aNuclear Medicine bCardiology cBiostatistics, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
authors: Semra
authors: S
authors: Ozdemir
authors: Yusuf Ziya
authors: YZ
authors: Tan
authors: Yücel
authors: Y
authors: Colkesen
authors: Ahmet
authors: A
authors: Temiz
authors: Fatmanur
authors: F
authors: Turker
authors: Semra
authors: S
authors: Akgoz
mesh_terms: D000368:Aged; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000453:epidemiology; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology; D055414:Myocardial Perfusion Imaging / Q000379:methods; D015995:Prevalence; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi; D016276:Ventricular Function / Q000502:physiology*
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi