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Relation of fragmented QRS complex to right ventricular fibrosis detected by late gadolinium enhancement cardiac magnetic resonance in adults with repaired tetralogy of fallot.
Am J Cardiol. 2012 Jan 01; 109(1):110-5.AJ

Abstract

Fragmented QRS (fQRS) on 12-lead electrocardiography reflects conduction delay caused by myocardial fibrosis and dysfunction. Ventricular fibrosis detected by late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) is reportedly correlated with worse clinical outcomes in adults with repaired tetralogy of Fallot (TOF). The aim of this study was to assess whether the presence of fQRS is associated with right ventricular (RV) fibrosis or dysfunction in this patient group. In 37 consecutive patients (median age 30 years, median age at repair 6.6 years), the number of leads showing fQRS, defined as the presence of >2 notches on the R/S wave in ≥2 contiguous leads, was counted. RV systolic function, dilatation, and LGE score were measured using LGE CMR. Ventricular LGE was observed mainly at the previous surgical sites: the RV outflow tract (33 of 37), ventricular septal defect patch region (15 of 37), and RV anterior wall (11 of 37). Fragmented QRS was found mostly in the right and mid precordial leads. The fQRS group (n = 20) demonstrated higher RV LGE scores (p <0.001) and lower RV ejection fractions (p = 0.02) and a trend toward larger RV end-diastolic and end-systolic volumes (p = 0.12 and p = 0.06, respectively) compared to the non-fQRS group (n = 17). The number of electrocardiographic leads showing fQRS was positively correlated with RV LGE score (r = 0.75, p <0.001). The presence of fQRS remained independently associated with the presence of supramedian RV LGE score, even after adjusting for relevant parameters. In conclusion, fQRS was closely associated with more extensive RV fibrosis and dysfunction in adults with repaired tetralogy of Fallot.

Authors+Show Affiliations

Department of Internal Medicine, Cardiovascular Imaging Center, Sungkyunkwan University School of Medicine, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21962997

Citation

Park, Seung-Jung, et al. "Relation of Fragmented QRS Complex to Right Ventricular Fibrosis Detected By Late Gadolinium Enhancement Cardiac Magnetic Resonance in Adults With Repaired Tetralogy of Fallot." The American Journal of Cardiology, vol. 109, no. 1, 2012, pp. 110-5.
Park SJ, On YK, Kim JS, et al. Relation of fragmented QRS complex to right ventricular fibrosis detected by late gadolinium enhancement cardiac magnetic resonance in adults with repaired tetralogy of fallot. Am J Cardiol. 2012;109(1):110-5.
Park, S. J., On, Y. K., Kim, J. S., Park, S. W., Yang, J. H., Jun, T. G., Kang, I. S., Lee, H. J., Choe, Y. H., & Huh, J. (2012). Relation of fragmented QRS complex to right ventricular fibrosis detected by late gadolinium enhancement cardiac magnetic resonance in adults with repaired tetralogy of fallot. The American Journal of Cardiology, 109(1), 110-5. https://doi.org/10.1016/j.amjcard.2011.07.070
Park SJ, et al. Relation of Fragmented QRS Complex to Right Ventricular Fibrosis Detected By Late Gadolinium Enhancement Cardiac Magnetic Resonance in Adults With Repaired Tetralogy of Fallot. Am J Cardiol. 2012 Jan 1;109(1):110-5. PubMed PMID: 21962997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relation of fragmented QRS complex to right ventricular fibrosis detected by late gadolinium enhancement cardiac magnetic resonance in adults with repaired tetralogy of fallot. AU - Park,Seung-Jung, AU - On,Young Keun, AU - Kim,June Soo, AU - Park,Seung Woo, AU - Yang,Ji-Hyuk, AU - Jun,Tae-Gook, AU - Kang,I-Seok, AU - Lee,Heung Jae, AU - Choe,Yeon Hyeon, AU - Huh,June, Y1 - 2011/09/29/ PY - 2011/06/17/received PY - 2011/07/29/revised PY - 2011/07/29/accepted PY - 2011/10/4/entrez PY - 2011/10/4/pubmed PY - 2012/2/9/medline SP - 110 EP - 5 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 109 IS - 1 N2 - Fragmented QRS (fQRS) on 12-lead electrocardiography reflects conduction delay caused by myocardial fibrosis and dysfunction. Ventricular fibrosis detected by late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) is reportedly correlated with worse clinical outcomes in adults with repaired tetralogy of Fallot (TOF). The aim of this study was to assess whether the presence of fQRS is associated with right ventricular (RV) fibrosis or dysfunction in this patient group. In 37 consecutive patients (median age 30 years, median age at repair 6.6 years), the number of leads showing fQRS, defined as the presence of >2 notches on the R/S wave in ≥2 contiguous leads, was counted. RV systolic function, dilatation, and LGE score were measured using LGE CMR. Ventricular LGE was observed mainly at the previous surgical sites: the RV outflow tract (33 of 37), ventricular septal defect patch region (15 of 37), and RV anterior wall (11 of 37). Fragmented QRS was found mostly in the right and mid precordial leads. The fQRS group (n = 20) demonstrated higher RV LGE scores (p <0.001) and lower RV ejection fractions (p = 0.02) and a trend toward larger RV end-diastolic and end-systolic volumes (p = 0.12 and p = 0.06, respectively) compared to the non-fQRS group (n = 17). The number of electrocardiographic leads showing fQRS was positively correlated with RV LGE score (r = 0.75, p <0.001). The presence of fQRS remained independently associated with the presence of supramedian RV LGE score, even after adjusting for relevant parameters. In conclusion, fQRS was closely associated with more extensive RV fibrosis and dysfunction in adults with repaired tetralogy of Fallot. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/21962997/Relation_of_fragmented_QRS_complex_to_right_ventricular_fibrosis_detected_by_late_gadolinium_enhancement_cardiac_magnetic_resonance_in_adults_with_repaired_tetralogy_of_fallot_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(11)02559-8 DB - PRIME DP - Unbound Medicine ER -