title: Association of fragmented QRS complexes on ECG with left ventricular diastolic function in hypertensive patients.
abstract: OBJECTIVE
  Diastolic dysfunction occurs as a result of interstitial fibrosis in hypertensive patients. Fragmented QRS (fQRS) on ECG signifies myocardial fibrosis in various clinical situations. We investigated whether fQRS on ECG is related to diastolic dysfunction in patients with hypertension.
  
  
  METHODS
  The study population included 72 hypertensive patients with normal coronary angiogram. Fragmented QRS was defined as the presence of an additional R wave (R'), notching of the R or S wave or fragmentation in two contiguous leads corresponding to a major coronary artery. Echocardiography was performed to all patients to detect diastolic dysfunction. Diastolic dysfunction was regarded as non-severe if patients had normal diastolic function or grade 1 diastolic dysfunction or severe if they had grade ≥2 diastolic dysfunction.
  
  
  RESULTS
  Thirty-two patients had fQRS on ECGs (fQRS [+] group) and there were 40 patients who did not have fQRS on their ECGs (fQRS [-] group). The two groups were similar in terms of baseline characteristics. In patients with fQRS on the ECG, severe diastolic dysfunction was more prevalent (59.4% vs. 7.5%, p<0.001). The duration of hypertension was longer in patients with fQRS on the ECG (p<0.001). The presence of fQRS on the ECG was an indicator for severe diastolic dysfunction (B=1.954; odds ratio=7; 95% confidence interval=1.4-35.4; p=0.018).
  
  
  CONCLUSIONS
  The presence of fQRS complexes on ECG predicts more severe diastolic dysfunction in patients with hypertension.
authors.affiliation: Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey. drhkadi@gmail.com.
authors.forename: Hasan
authors.initials: H
authors.lastname: Kadı
authors.affiliation: Department of Internal Medicine, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors.forename: Ayşe Kevser
authors.initials: AK
authors.lastname: Demir
authors.affiliation: Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors.forename: Köksal
authors.initials: K
authors.lastname: Ceyhan
authors.affiliation: Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors.forename: İbrahim Halil
authors.initials: İH
authors.lastname: Damar
authors.affiliation: Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors.forename: Kayıhan
authors.initials: K
authors.lastname: Karaman
authors.affiliation: Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
authors.forename: Çağrı
authors.initials: Ç
authors.lastname: Zorlu
mesh_terms: D003971:Diastole; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography; D016277:Ventricular Function, Left / Q000502:physiology*