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
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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

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