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    Fragmented QRS complexes are a marker of myocardial fibrosis in hypertensive heart disease
    (Turkish Society of Cardiology, 2016) Bekar, Lütfü; Katar, Muzaffer; Yetim, Mücahit; Çelik, Oğuzhan; Kilci, Hakan; Önalan, Orhan
    Objective: Carboxy-terminal propeptide of type 1 procollagen (PICP) is a marker of extracellular collagen synthesis. Fragmented QRS (fQRS) on a 12-lead electrocardiogram (ECG) has been demonstrated as a marker of myocardial fibrosis. The present objective was to investigate the association between serum PICP concentration and presence of fQRS on ECG in hypertensive patients. Methods: Consecutive patients with previously or newly diagnosed hypertension were included. fQRS was defined as the presence of additional R-wave (R?), or notching of R- or Swaves, or the presence of fragmentation in 2 contiguous ECG leads. Serum PICP levels were measured by ELISA method. Results: The study group consisted of 90 hypertensive patients (74% females, with a mean age of 54.7±8.5 years). Of these patients, 47 (52.2%) had fQRS on ECG. Age (p=0.121) and gender distribution (p=0.625) were similar in patients with or without fQRS. Receiver operating characteristic curve analysis yielded a strong predictive ability of PICP levels for the presence of fQRS (area under the curve: 0.850; 95% CI: 0.772-0.929; p<0.0001). In multivariate logistic regression analysis, PICP levels were strongly and independently associated with the presence of fQRS (OR: 1.938; 95% CI: 1.398-2.688). Conclusion: Serum PICP level is a strong and independent predictor of fQRS. Discriminative performance of serum PICP levels for the presence of fQRS is high. The present results are the first to demonstrate that fQRS may indicate myocardial fibrosis in patients with hypertension. © 2016 Turkish Society of Cardiology.
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    Öğe
    Investigation of ICAM-1 levels in hypertensive patients with fragmented QRS complexes
    (Taylor and Francis Ltd., 2019) Bekar, Lütfü; Kalçık, Macit; Katar, Muzaffer; Yetim, Mücahit; Çelik, Oğuzhan; Doğan, Tolga; Karavelioğlu, Yusuf; Gölbaşı, Zehra
    Objective: Fragmented QRS (fQRS) detected on a 12-lead electrocardiogram (ECG) has been demonstrated to be a marker of myocardial fibrosis. Intercellular adhesion molecule-1 (ICAM-1) is a protein which plays an important role in fibro-inflammatory processes. In this study, we aimed to investigate the relationship between ICAM-1 levels and the presence of fQRS in hypertensive patients. Methods: Ninety consecutive patients who were diagnosed with hypertension were included in the study. ECG and transthoracic echocardiography were performed to all patients. fQRS was defined as additional R’ wave or notching/splitting of S wave in two contiguous ECG leads. Serum ICAM-1 levels were measured using the enzyme-linked immunosorbent assay method. Patients were divided into two groups according to the presence of fQRS. Results: A total of 90 patients (female, 65%; mean age: 54.6 ± 8.5 years) were included in the study. fQRS was detected on ECG recordings of 47 (52.2%) patients. The demographic characteristics were similar between the groups. Left atrial diameter (p =.003), interventricular septal thickness (p =.013), posterior wall thickness (p =.01), left ventricular mass (p =.002), left ventricular mass index (p <.001), left ventricular hypertrophy (p =.001), and ICAM-1 levels (p <.001) were found to be significantly increased in fQRS(+) group. In multivariate analysis, only high ICAM-1 level was observed to be an independent predictor for the presence of fQRS (odds ratio: 1.029; 95%Confidence Interval: 1.013–1.045, p <.001). Conclusion: A significant association exists between serum ICAM-1 levels and the presence of fQRS in hypertensive patients. The presence of fQRS may be used as an indicator of inflammation in hypertensive patients. © 2019, © 2019 Belgian Society of Cardiology.