title: Fragmented QRS complexes are associated with increased left ventricular mass in patients with essential hypertension.
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH) is an independent predictor of poor prognosis in patients with hypertension. In hypertensive hypertrophy, the pathophysiological mechanism is the accumulation of collagen in the myocardium. Fragmented QRS (fQRS) complexes are associated with myocardial fibrosis.
  
  
  METHODS
  The study population included 90 patients with hypertension and a normal coronary angiogram. The fQRS was defined as the presence of an additional R wave (R'), notching of the R or S wave, or the presence of fragmentation in two contiguous leads corresponding to a major coronary artery. Echocardiographic examinations were performed according to the recommendations of the American Society of Echocardiography.
  
  
  RESULTS
  Forty-five patients who had fQRS and were suitable for the study criteria were compared with 45 age- and gender-matched patients who did not have fQRS according to demographic data and echocardiographic findings. The left ventricular (LV) mass index (g/m(2) ) was significantly higher (P < 0.001) in the group with fQRS. The wall thickness, diameter, volume, and ejection fraction (EF) were higher in this group (P < 0.001). Concentric and eccentric hypertrophy were also higher in this group (P < 0.001). In the logistic regression analysis, fQRS on ECG was an indicator of LVH in hypertensive patients (B = 0.064; P < 0.001; odds ratio = 1.066; 95% confidence interval = 1.041-1.092) CONCLUSION: The LV mass index of the hypertensive patients who had fQRS on their ECGs was significantly higher than that of the patients who did not, and fQRS on ECG was an important indicator of LVH in hypertensive patients.
authors.affiliation: Gaziosmanpasa University Faculty of Medicine, Department of Cardiology, Tokat, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Kadi
authors.forename: Ayşe
authors.initials: A
authors.lastname: Kevser
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozturk
authors.forename: Fatih
authors.initials: F
authors.lastname: Koc
authors.forename: Koksal
authors.initials: K
authors.lastname: Ceyhan
mesh_terms: D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric
keywords: fragmented QRS; hypertension; left ventricular hypertrophy