title: Fragmented QRS is associated with cirrhotic cardiomyopathy in patients with decompensated cirrhosis.
abstract: OBJECTIVE
  It has been reported that the fragmented QRS (fQRS) is related to left ventricular systolic dysfunction and diastolic dysfunction. The aim of this study was to determine the frequency of fragmented QRS (fQRS) in patients with decompensated cirrhosis and to evaluate the relationship between the presence of fQRS and systolic and diastolic dysfunction.
  
  
  METHODS
  PThe study included consecutive 189 patients with decompensated cirrhosis. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings. Conventional echocardiography and tissue doppler echocardiography were performed in all patients.
  
  
  RESULTS
  The prevalence of fQRS was 31% (59/189) in patients with decompensated cirrhosis. The patients with fQRS had worse diastolic and systolic functions in comparison to the patients without fQRS. In addition, multivariate analysis revealed that the presence of an fQRS, Na levels < 125 mEq/L, the Child-Pugh score and the MELD score were independent predictive factors for mortality (respectively, p < 0.001, p < 0.001, p < 0.001 and p < 0.001).
  
  
  CONCLUSIONS
  In conclusion,this study showed a relationship between the presence of an fQRS and cardiac dysfunction. In addition, the fQRS appeared to act as an independent predictor of mortality in patients with decompensated cirrhosis. These data suggest that the fQRS may represent a novel noninvasive marker for cardiac involvement and for predicting mortality in patients with decompensated cirrhosis.
authors.forename: M
authors.initials: M
authors.lastname: Demir
authors.forename: M
authors.initials: M
authors.lastname: Kurt
authors.forename: A B
authors.initials: AB
authors.lastname: Akçay
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D053840:Brugada Syndrome / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D000075224:Cardiac Conduction System Disease; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D004452:Echocardiography; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D058625:End Stage Liver Disease; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000453:epidemiology / Q000378:metabolism; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000378:metabolism / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012709:Serum Albumin / Q000378:metabolism; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D012709:Serum Albumin