Fragmented QRS is independently predictive of long-term adverse clinical outcomes in Asian patients hospitalized for heart failure: A retrospective cohort study

Journal article


Chan, Jeffrey Shi Kai, Zhou, Jiandong, Lee, Sharen, Li, Andrew, Tan, Martin, Leung, Keith Sai Kit, Jeevaratnam, Kamalan, Liu, Tong, Roever, Leonardo, Liu, Ying, Tse, Gary and Zhang, Qingpeng 2021. Fragmented QRS is independently predictive of long-term adverse clinical outcomes in Asian patients hospitalized for heart failure: A retrospective cohort study. Frontiers in Cardiovascular Medicine. 8, p. 738417. https://doi.org/10.3389/fcvm.2021.738417
AuthorsChan, Jeffrey Shi Kai, Zhou, Jiandong, Lee, Sharen, Li, Andrew, Tan, Martin, Leung, Keith Sai Kit, Jeevaratnam, Kamalan, Liu, Tong, Roever, Leonardo, Liu, Ying, Tse, Gary and Zhang, Qingpeng
Abstract Fragmented QRS (fQRS) results from myocardial scarring and predicts cardiovascular mortality and ventricular arrhythmia (VA). We evaluated the prevalence and prognostic value of fQRS in Asian patients hospitalized for heart failure. This was a retrospective cohort study of adult patients hospitalized for heart failure between 1st January 2010 and 31st December 2016 at a tertiary center in Hong Kong. The baseline ECG was analyzed. QRS complexes (<120 ms) with fragmented morphology in ≥2 contiguous leads were defined as fQRS. The primary outcome was a composite of cardiovascular mortality, VA, and sudden cardiac death (SCD). The secondary outcomes were the components of the primary outcome, myocardial infarction, and new-onset atrial fibrillation. In total, 2,182 patients were included, of whom 179 (8.20%) had fQRS. The follow-up duration was 5.63 ± 4.09 years. fQRS in any leads was associated with a higher risk of the primary outcome (adjusted hazard ratio (HR) 1.428 [1.097, 1.859], = 0.001), but not myocardial infarction or new-onset atrial fibrillation. fQRS in >2 contiguous leads was an independent predictor of SCD (HR 2.679 [1.252, 5.729], = 0.011). In patients without ischaemic heart disease ( = 1,396), fQRS in any leads remained predictive of VA and SCD (adjusted HR 3.526 [1.399, 8.887], = 0.008, and 1.873 [1.103, 3.181], = 0.020, respectively), but not cardiovascular mortality (adjusted HR 1.064 [0.671, 1.686], = 0.792). fQRS is an independent predictor of cardiovascular mortality, VA, and SCD. Higher fQRS burden increased SCD risk. The implications of fQRS in heart failure patients without ischaemic heart disease require further studies. [Abstract copyright: Copyright © 2021 Chan, Zhou, Lee, Li, Tan, Leung, Jeevaratnam, Liu, Roever, Liu, Tse and Zhang.]
KeywordsFragmented QRS; Myocardial fibrosis; Asian; Sudden cardiac death; Ventricular arrhythmia; Heart failure
Year2021
JournalFrontiers in Cardiovascular Medicine
Journal citation8, p. 738417
ISSN2297-055X
Digital Object Identifier (DOI)https://doi.org/10.3389/fcvm.2021.738417
Official URLhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.738417/full
Publication dates
Online11 Nov 2021
Publication process dates
Accepted22 Oct 2021
Deposited20 Dec 2021
Publisher's version
License
Output statusPublished
Permalink -

https://repository.canterbury.ac.uk/item/8zy28/fragmented-qrs-is-independently-predictive-of-long-term-adverse-clinical-outcomes-in-asian-patients-hospitalized-for-heart-failure-a-retrospective-cohort-study

Download files


Publisher's version
Asian fragmented heart.pdf
License: CC BY 4.0

  • 7
    total views
  • 0
    total downloads
  • 5
    views this month
  • 0
    downloads this month

Export as

Related outputs

Cardiac abnormalities after induction of endoplasmic reticulum stress are associated with mitochondrial dysfunction and connexin43 expression
He, Jinli, Gong, Mengqi, Wang, Zaojia, Liu, Daiqi, Xie, Bingxin, Luo, C., Li, Guangping, Tse, Gary and Liu, T. 2021. Cardiac abnormalities after induction of endoplasmic reticulum stress are associated with mitochondrial dysfunction and connexin43 expression. Clinical and Experimental Pharmacology and Physiology. https://doi.org/10.1111/1440-1681.13541
Hip fractures risks in edoxaban versus warfarin users: A propensity score-matched population-based cohort study with competing risk analyses
Zhou, Jiandong, Lee, Sharen, Liu, Xuejin, Iltaf Satti, Danish, Tai Loy Lee, Teddy, Hou In Chou, Oscar, Chang, Carlin, Roever, Leonardo, Tak Wong, Wing, Ka Chung Wai, Abraham, Liu, Tong, Zhang, Qingpeng and Tse, Gary 2021. Hip fractures risks in edoxaban versus warfarin users: A propensity score-matched population-based cohort study with competing risk analyses. Bone. 156, p. 116303. https://doi.org/S8756-3282(21)00469-5
Atrial cardiomyopathy: An emerging cause of the embolic stroke of undetermined source
Ning, Yuye, Tse, G., Luo, Guogang and Li, Guoliang 2021. Atrial cardiomyopathy: An emerging cause of the embolic stroke of undetermined source. Frontiers in Cardiovascular Medicine. 8, p. 674612. https://doi.org/10.3389/fcvm.2021.674612
Heart failure with midrange ejection fraction: Prior left ventricular ejection fraction and prognosis
Zhang, Xinxin, Sun, Yuxi, Zhang, Yanli, Chen, Feifei, Zhang, Shuyuan, He, Hongyan, Song, Shuang, Tse, Gary and Liu, Ying 2021. Heart failure with midrange ejection fraction: Prior left ventricular ejection fraction and prognosis. Frontiers in Cardiovascular Medicine. 8, p. 697221. https://doi.org/10.3389/fcvm.2021.697221
Ventricular tachyarrhythmia risk in paediatric/young vs. adult Brugada Syndrome patients: A territory-wide study
Lee, Sharen, Wong, Wing Tak, Wong, Ian Chi Kei, Mak, Chloe, Mok, Ngai Shing, Liu, Tong and Tse, Gary 2021. Ventricular tachyarrhythmia risk in paediatric/young vs. adult Brugada Syndrome patients: A territory-wide study. Frontiers in Cardiovascular Medicine. 8, p. 671666. https://doi.org/10.3389/fcvm.2021.671666
The association between blood pressure variability and hip or vertebral fracture risk: A population-based study
Zhou, Jiandong, Li, Helen, Chang, Carlin, Wu, William K.K., Wang, Xiansong, Liu, Tong, Cheung, Bernard Man Yung, Zhang, Qingpeng, Lee, Sharen and Tse, Gary 2021. The association between blood pressure variability and hip or vertebral fracture risk: A population-based study. Bone. 150, p. 1160115. https://doi.org/10.1016/j.bone.2021.116015