Relationship Between Epicardial Adipose Tissue Thickness and Fragmented QRS

Abstract

Introduction: Fragmented QRS (fQRS) on a 12-lead electrocardiogram (ECG) has been demonstrated as a marker of myocardial fibrosis. The main purpose of present study was to investigate the association between epicardial adipose tissue (EAT) and fQRS.Patients and Methods: Study population consisted of 151 patients had fQRS detected on a routine 12-lead ECG and 114 controls without fQRS. EAT was assessed by measuring epicardial fat thickness with echocardiography. fQRS was defined by the presence of various RSR' patterns included an additional R wave (R), notching of the R wave, notching of the downstroke or upstroke of the S wave, or the presence of > 1 R in 2 contiguous leads corresponding to a major coronary artery territory.Results: Patients with fQRS had higher EAT values than those without fQRS (5.9 ± 2.7, 3.8 ± 2.3, p< 0.001). Univariate analyses demonstrated significant association between fQRS and EAT (p< 0.001), hypertension (p= 0.015). Binary logistic regression analysis revealed EAT (95% confidence interval [CI] 1.053-1.938, p= 0.022) and total cholesterol (95% CI: 1.001-1.030, p= 0.037) as independent determinants of fQRS. Conclusion:In the present study, we found higher amounts of EAT in subjects with fQRS. In addition, presence of fQRS was independently associated with EAT. Hastalar ve Yöntem:Çalışmaya kardiyoloji polikliniğimize müracaat edip rutin eloktrokardiyografik incelemede pQRS'si olan 151 hasta ve kontrol grubu olarak pQRS'si olmayan 114 hasta alındı. EYK ekokardiyografide hesaplandı. Parçalanmış QRS birbirini takip eden iki EKG derivasyonunda ilave R dalgası (R') veya R veya S dalgasında çentiklenme veya bölünme varlığı olarak alındı. Bulgular: pQRS olan hastalarda EYK değerleri daha yüksekti (5.9 ± 2.7, 3.8 ± 2.3, p< 0.001). Tek değişkenli analiz EYK ile pQRS (p< 0.001) ve hipertansiyon (p= 0.015) arasında anlamlı bir ilişki olduğunu göstermiştir. Binary lojistik regresyon analizi, EYK [%95 güven aralığı (GA) 1.053-1.938, p= 0.022] ve total kolesterolü (%95 GA: 1.00-1.030, p= 0.037) pQRS'nin bağımsız bir belirleyicisi olarak ortaya koydu.Sonuç: Bu çalışmada, pQRS'li hastalarda EYK'yi artmış olarak tespit ettik. Buna ek olarak EYK, pQRS'nin güçlü ve bağımsız bir belirteci olarak bulunmuştur.Anahtar Kelimeler: Parçalı QRS; epikardiyal yağ dokusu; miyokardiyal fibrozis

Effect of Echocardiographic Epicardial Adipose Tissue Thickness on Success Rates of Premature Ventricular Contraction Ablation

“…They also found an independent association between EAT thickness and frequent PVCs. Akyüz et al (28) found an elevated epicardial fat thickness in patients with fragmented QRS compared to that in controls, which was considered as an indicator for myocardial fibrosis or scarring in a variety of diseases. Voulgari et al (29) reported the presence of a relationship between left ventricular arrhythmogenicity and low levels of inflammation in metabolic syndrome.…”

“…EAT is not only adjacent to the atria, but it is also associated with autonomic ganglia and is the probable mechanism leading to arrhythmia (8). Several studies have demonstrated that EAT thickness is associated with some common disorders such as increased left ventricular mass, atherosclerosis, arterial stiffness, hypertension, and atrial fibrillation (9). Additional studies that have been conducted recently have emphasized the presence of a relationship between EAT thickness and atrial fibrillation existence and its postablation recurrence (10).…”