Association of fragmented QRS complexes on ECG with left ventricular diastolic function in hypertensive patients

OZET H is one of the most common diseases in the world and the major cause of cardiac arrhythmias, left ventricular hypertrophy (LVH), coronary artery disease, stroke, renal failure, and systolic and diastolic heart failure. About half of hypertensive patients with heart failure symptoms have diastolic heart failure, a severe condition.[1] Causes of left ventricular (LV) diastolic dysfunction are impaired ventricular relaxation and decreased compliance in patients with hypertension. Although the pathophysiological mechanism of LV diastolic dysfunction in hypertensive patients is multifactorial, interstitial fibrosis and accumulation of type I and III collagen in the myocardium play a significant role.[2] These alterations in hypertensive hearts account for the development of LV diastolic dysfunction.[3] On the other hand, it has been reported that degree of myocardial fibrosis is the most significant factor related to diastolic dysfunction in patient with hypertension.[4] Fragmented QRS (fQRS) complexes are defined as changes in QRS morphology with different RSR’ patterns. Cardiac magnetic resonance imaging (CMR) and myocardial single-photon emission tomography (SPECT) studies have shown that presence of fQRS on ECG signifies myocardial fibrosis.[5,6] The presence of fQRS complexes on 12-lead ECG has been found to be associated with all-cause mortality and recurrent cardiac events.[7] Recently, Brenyo et al.[8] reported that the presence of fQRS complexes on ECG were an independent predictor for sudden cardiac death in a patient with idiopathic dilated cardiomyopathy. The aim of this study was to investigate the relationship between fQRS complexes on ECG and LV diastolic function in hypertensive patients. We hypothesized that fQRS on ECGs would be related to severe diastolic abnormalities in patients with hypertension. PATIENTS AND METHODS