Document Detail

Fragmented QRS is predictive of myocardial dysfunction, pulmonary hypertension and severity in mitral stenosis.
MedLine Citation:
PMID:  20383039     Owner:  NLM     Status:  MEDLINE    
Reliable non-invasive new indices reflecting severity of rheumatic valve disease would be highly beneficial. Recently, presence of fragmented QRS (fQRS) in ECG was accepted as a marker of myocardial fibrosis. fQRS is defined as the presence of RSR' patterns such as additional R wave (R'), notching in the R wave or the S wave in 2 contiguous leads. Purpose of our study was to establish frequency of fQRS in isolated rheumatic mitral stenosis compared with control group. We studied 193 patients with mitral stenosis and age/gender matched 97 healthy subjects. Patients were categorized according to the New York Heart Association (NYHA) functional class. Severity of mitral stenosis, left ventricular ejection fraction, and pulmonary artery pressure were obtained by means of echocardiography. fQRS was defined on routine 12-lead ECG. fQRS was more frequent in subjects with mitral stenosis than in control group (p < 0.001). fQRS was associated with low ejection fraction, pulmonary hypertension, poor functional NYHA class, increased mean mitral valve gradient and decreased mitral valve area (R = 0.1, p = 0.02; R = 0.1, p = 0.001; R = 0.1, p = 0.01; R = 0.1, p = 0.04; and R = -0.1, p = 0.009, respectively). Mitral valve area was the only independent predictor of fQRS in multiple logistic regression analysis. In conclusion, fQRS is predictive of severe mitral stenosis, lower ejection fraction, increased pulmonary artery pressure, and poor functional class. fQRS might be considered as a novel indicator of mitral stenosis severity and associated complications.
Murat Yuce; Vedat Davutoglu; Burcu Ozbala; Suleyman Ercan; Nese Kizilkan; Murat Akcay; Ibrahim Sari; Cayan Akkoyun; Adnan Dogan; M Hayri Alici; Fethi Yavuz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Tohoku journal of experimental medicine     Volume:  220     ISSN:  1349-3329     ISO Abbreviation:  Tohoku J. Exp. Med.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-12     Completed Date:  2010-07-07     Revised Date:  2013-01-03    
Medline Journal Info:
Nlm Unique ID:  0417355     Medline TA:  Tohoku J Exp Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  279-83     Citation Subset:  IM    
Cardiology Department, Gaziantep University, School of Medicine, Gaziantep, Turkey.
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MeSH Terms
Heart / physiopathology*
Hypertension, Pulmonary / etiology*,  physiopathology
Mitral Valve Stenosis / complications*,  pathology,  physiopathology
Myocardium / pathology*
Rheumatic Heart Disease / complications,  pathology

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