Relationship Between Fragmented QRS Complex and Long-Term Cardiovascular Outcome in Patients with Essential Hypertension

Abstract

Background: In patients with essential hypertension, fragmented QRS has been associated with many remodeling components that might lead to adverse cardiovascular effects. This study aimed to evaluate the relationship between fragmented QRS and adverse events and its potential long-term prognostic value. Methods: The patients with essential hypertension were divided into two groups accord- ing to the presence of fragmented QRS: fragmented QRS (+) and fragmented QRS (−). During long-term follow-up, the relationship of fragmented QRS to coronary artery dis-ease, congestive heart failure, stroke, cardiovascular death, all-cause death, and major adverse cardiovascular and cerebrovascular events was evaluated. Results: The study group included 542 patients with essential hypertension. Fragmented QRS on ECG was observed in 224 (41.3%) patients. Considering the incidence rates at the end of 5.6 +- 1.3 years' follow-up, the total incidence rate of major adverse cardiovascular and cerebrovascular events (P <.001), coronary artery disease (P <.001), and congestive heart failure (P <.001) were higher in patients with fragmented QRS. No significant difference was observed between the two groups in terms of stroke (P =.734), cardiovascular death (P = 1), and all-cause death (P =.574). As a result of multiple cox regression analysis, fragmented QRS (P =.005) was identified as an independent predictor for major adverse cardiovascular and cerebrovascular events development. Conclusion: In patients with hypertension, the presence of fragmented QRS was found as an independent predictor for major adverse cardiovascular and cerebrovascular events development.

Keywords

• essential hypertension
• fragmented qrs
• major adverse cardiovascular and cerebrovascular events
• mortality