Electrocardiographic Signs of Remote Myocardial Infarction

Michael, Mark A.; Masry, Hicham El; Khan, Bilal; Das, Mithilesh K.

doi:10.1016/j.pcad.2007.05.003

Cited by 71 publications

(61 citation statements)

References 54 publications

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“…Scar or fibrotic tissue, resulting from cardiac remodeling after ischemic heart disease or cardiomyopathy, can lead to hemodynamically significant arrhythmias and congestive heart failure, and eventually to cardiovascular death. The presence of fQRS has been demonstrated to be an independent predictor of impaired myocardial perfusion and left ventricular function detected by myocardial single-photon emission computed tomography imaging in patients with ischemic heart disease [9,22,23]. Moreover, fQRS, which may be widened or narrowed, has been reported to be related with a high incidence of major adverse cardiovascular events, including mortality due to hemodynamically significant ventricular arrhythmic events in CAD, acute coronary syndromes [24,25], hypertrophic obstructive cardiomyopathy [26], ischemic and non-ischemic cardiomyopathy [27,28], and decompensated systolic heart failure [29].…”

Section: Discussionmentioning

confidence: 99%

Assessment of the relationship between a narrow fragmented QRS complex and coronary slow flow

Çakmak¹,

Aslan

Gül

et al. 2015

Cardiol J

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Section: Discussionmentioning

confidence: 99%

Assessment of the relationship between a narrow fragmented QRS complex and coronary slow flow

Çakmak¹,

Aslan

Gül

et al. 2015

Cardiol J

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“…In this study, we measured the mean serum ferritin level of previous 5 years in order to better estimate the consequence of chronic iron myocardial accumulation. Fragmented QRS complexes on a routine 12-lead electrocardiogram is suggested as novel another marker of depolarization abnormality and myocardial scar in patients with coronary artery disease [5,6,18] . It has been shown that the presence of fQRS in ≥ 2 contiguous leads predicts myocardial scar in patients with coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

“…at fQRS proved to be a novel marker pointing out possible existence of myocardial scar was documented in the patients with coronary arterial disease [6].…”

mentioning

confidence: 99%

The relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major

Büyükkaya

Karakaş

Kurt

et al. 2012

CIM

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Turkey e relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major AbstractPurpose: e most important complication encountered in patients with b-thalassaemia major is degenerative brosis developing as a result of iron accumulation in myocardial tissue. Dysfunction pursues this accumulation. Recently, presence of fragmented QRS (fQRS) in ECG has been regarded as a predictor of myocardial brosis. We aimed in our study to investigate the frequency with which fQRS develops in patients with bthalassaemia major and to disclose the correlation between fQRS frequency and Dopplerderived indices.Methods: e patients with b-thalassaemia major (n=66; mean age: 23±6 years) and healthy controls (n=30; mean age: 23±4 years) were included. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings. 2D, M-mode, conventional Doppler, tissue Doppler echocardiography parameters were assessed. Mean serum ferritin levels over past 5 years were also calculated.Results: When compared to those in control group, fQRS was more frequent in bthalassaemia major group, indicating statistical signi cance (p = 0.001). While E/Em and ferritin level exhibited statistically signi cant increase in thalassaemia patients with fQRS (p < 0.05), the mean Em and Sm values were found to be signi cantly low (p < 0.05).Conclusions: fQRS was frequently observed in the patients with b-thalassaemia major, which was of statistical signi cance. Tissue Doppler-derived diastolic and systolic indices in thalassaemia cases with fQRS showed statistically signi cant impairment compared to those without fQRS. In conclusion, fQRS may represent a novel noninvasive marker for cardiac involvement in patients with b-thalassaemia major. e most important complication in patients with bthalassaemia major is cardiac dysfunction due to accumulation of iron in myocardial cells [1]. Heart failure holds the topmost position among the mortality reasons in patients with bthalassaemia major [2]. 50% of the cases with thalassaemia major are complicated with manifest heart failure, for which reason early diagnosis may prove helpful in the treatment [3,4].Recently, existence of fragmented QRS (fQRS) in ECG strips has been regarded as a predictor of myocardial brosis [5]. at fQRS proved to be a novel marker pointing out possible existence of myocardial scar was documented in the patients with coronary arterial disease [6].Various number of parameters related to conventional Doppler echocardiography was used during investigations on the cardiac functioning in the patients with b-thalassaemia until now [7]. We used in our study the tissue Doppler imaging modality which has less technical limitations compared to conventional Doppler echocardiography.What we aimed in this study was to disclose relationship between tissue Doppler echocardiography-derived indices and frequency of fQRS, a possibly novel indicator that may be used in the early identi cation of cardia...

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“…Malignant arrhythmia (mainly ventricular fibrillation) is usually the primary manifestation and accounts for 50% of the mortality (Wang and Zhao, 2011) while heart failure is commonly seen in patients with a large area of myocardial infarction (>40%) and sometimes results in cardiogenic shock. As a new electrocardiographic index, fragmented QRS (fQRS) has been proved to be a valuable tool for detecting myocardial infarction (France et al, 1990;Michael et al, 2007;Xu and Qi, 2009), as well as predicting the incidence of malignant cardiac arrhythmia and left ventricular systolic dysfunction (LVSD) (Guo, 2008;Cheema et al, 2010). However, the correlation between incidence of malignant cardiac arrhythmia, LVSD, or mortality and factors such as fQRS onset and duration, fQRS distribution in electrocardiography (ECG) leads, coronary lesion, ST segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), and percutaneous coronary intervention (PCI), is still poorly understood as there are only a few studies available on these subjects.…”

Section: Introductionmentioning

confidence: 99%

Correlation between fragmented QRS and the short-term prognosis of patients with acute myocardial infarction

Sheng

Hsu

et al. 2014

J. Zhejiang Univ. Sci. B

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This study is aimed to investigate the clinical significance and the short-term prognostic value of fragmented QRS (fQRS) for patients with acute myocardial infarction (AMI). Three hundred patients with AMI were tested with retrospective analysis on the patients' clinical information, hospitalized treatment, fQRS onset time, location of lesions, and other relevant data, in order to assess the relationship between the presence of fQRS and its prognosis. The rates of malignant cardiac arrhythmia, left ventricular systolic dysfunction (LVSD), and mortality in the positive fQRS group were 13.6%, 29.2%, and 23.7%, respectively, with all showing a p value <0.05. For the ST segment elevation myocardial infarction (STEMI) subgroup, all the rates showed significant differences with a p value <0.01, while for the non-STEMI (NSTEMI) subgroup showed no significant differences. In patients with a positive fQRS, there were no differences in malignant cardiac arrhythmia between patients with and without percutaneous coronary intervention (PCI) (p>0.05). As for the LVSD and mortality, the p values between patients with and without PCI were 0.031 and 0.000, respectively, suggesting statistical significance. The results imply that AMI patients with positive fQRS especially for the patients with STEMI had higher rates of malignant cardiac arrhythmia, LVSD, and mortality than the non-fQRS group. Patients of AMI with positive fQRS, who underwent early revascularization, could lower the incidence of the cardiovascular event. In addition, the presence of fQRS could be used as an indication of early intervention treatment for patients.

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Electrocardiographic Signs of Remote Myocardial Infarction

Cited by 71 publications

References 54 publications

Assessment of the relationship between a narrow fragmented QRS complex and coronary slow flow

Assessment of the relationship between a narrow fragmented QRS complex and coronary slow flow

The relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major

Correlation between fragmented QRS and the short-term prognosis of patients with acute myocardial infarction

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