title: Fragmented QRS complexes are associated with left ventricular systolic and diastolic dysfunctions in patients with metabolic syndrome.
abstract: BACKGROUND
  Metabolic syndrome (MetS) is found to be associated with deterioration of the left ventricular (LV) systolic and diastolic functions. One of the factors for this impairment is myocardial fibrosis. Fragmented QRS (fQRS) complexes are found to be associated with myocardial fibrosis. The aim of the study was to evaluate if the presence of fQRS on electrocardiogram (ECG) can detect pronounced impairment in the LV systolic and diastolic functions in MetS patients.
  
  
  METHODS
  The study included 111 (mean age 47 ± 9, 49.5% male) MetS patients and 96 (mean age 45 ± 9, 58.3% male) control subjects without MetS. ECG was evaluated for the presence of fQRS. Each patient underwent conventional echocardiography and tissue Doppler imaging.
  
  
  RESULTS
  Fragmented QRS was more common among MetS patients (26.1% vs. 14.6%, p = 0.041). MetS was associated with subclinical LV systolic and LV diastolic dysfunctions. In subgroup analyses of MetS patients, the presence of fQRS on ECG had a higher E/E' ratio and lower E' velocity, indicating pronounced diastolic dysfunction, as well as lower isovolumic acceleration(IVA), indicating profound subclinical LV systolic dysfunction. E/E' ratio and IVA were independent predictors of fQRS presence in patients with MetS.
  
  
  CONCLUSIONS
  Fragmented QRS is more common among MetS patients compared to non-MetS patients. The presence of fQRS is associated with pronounced subclinical LV systolic and diastolic dysfunctions in MetS patients.
authors.affiliation: Department of Cardiology, Stanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. enderoner7@gmail.com.
authors.forename: Ender
authors.initials: E
authors.lastname: Oner
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erturk
authors.forename: Ali
authors.initials: A
authors.lastname: Birant
authors.forename: Ali Kemal
authors.initials: AK
authors.lastname: Kalkan
authors.forename: Fatih
authors.initials: F
authors.lastname: Uzun
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Avci
authors.forename: Muhammet
authors.initials: M
authors.lastname: Gürdogan
authors.forename: Hamdi
authors.initials: H
authors.lastname: Pusuroglu
authors.forename: Aydin
authors.initials: A
authors.lastname: Yildirim
mesh_terms: D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D003971:Diastole; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D012189:Retrospective Studies; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: fragmented QRS; isovolumic acceleration; metabolic syndrome