We have located links that may give you full text access.
Association between fragmented QRS and exercise intolerance in hypertensive patients: the relation with coronary flow.
Blood Pressure 2019 January 23
OBJECTIVE: We aimed to investigate the relation between the presence of fragmented QRS (FQRS) and exercise intolerance as assessed by 6 minute walking test (6MWT) and its association with coronary flow reserve (CFR).
METHODS: One hundred and twenty patients with hypertension (age: 47.3 + 6.9) who were never treated and without left ventricular hypertrophy underwent 6MWT. Echocardiographic examination was obtained for all patients. CFR was calculated as the hyperemic to baseline mean velocity ratio (hyperemia was induced by intravenous adenosine 0.14 mg/kg/min). Patients were stratified into one group with FQRS and another group without FQRS. Forty-eight normotensive subjects with a mean age of 45.7 + 5.3 were recruited and served as a control group.
RESULTS: The frequency of FQRS was 49% in hypertensive patients versus 2% in control subjects. Patients with FQRS had higher systolic blood pressure (p < .05; <.01), a significant lower 6MWTD (p < .001), increased LAVI (p <.05), increased E/e' ratio (p < .01) and lower CFR (p < .001) compared with those without FQRS and controls. FQRS was inversely correlated with CFR (-0.531; p < .001) and 6 MWTD (-0.415; p < .001) and positively correlated with E/e' (0.352, p < .02) and LAVI (0.296; p < .05). By a multivariate regression analysis, FQRS (OR = 6.13; p < .001) and CFR (OR = 3.28; p < .001) were the only two independent predictors for decreased 6 MWTD in hypertensive patients. Importantly the ≥3 cutoff number of leads was found to be the best predictor of CFR < 2.0 in hypertensive patients.
CONCLUSION: FQRS is frequent and an independent predictor of reduced exercise tolerance in hypertensive patients. More so, it is significantly associated with decreased CFR and left ventricular diastolic dysfunction. In light of these findings, fragmented QRS might be considered a simple marker for risk stratification of hypertensive patients.
METHODS: One hundred and twenty patients with hypertension (age: 47.3 + 6.9) who were never treated and without left ventricular hypertrophy underwent 6MWT. Echocardiographic examination was obtained for all patients. CFR was calculated as the hyperemic to baseline mean velocity ratio (hyperemia was induced by intravenous adenosine 0.14 mg/kg/min). Patients were stratified into one group with FQRS and another group without FQRS. Forty-eight normotensive subjects with a mean age of 45.7 + 5.3 were recruited and served as a control group.
RESULTS: The frequency of FQRS was 49% in hypertensive patients versus 2% in control subjects. Patients with FQRS had higher systolic blood pressure (p < .05; <.01), a significant lower 6MWTD (p < .001), increased LAVI (p <.05), increased E/e' ratio (p < .01) and lower CFR (p < .001) compared with those without FQRS and controls. FQRS was inversely correlated with CFR (-0.531; p < .001) and 6 MWTD (-0.415; p < .001) and positively correlated with E/e' (0.352, p < .02) and LAVI (0.296; p < .05). By a multivariate regression analysis, FQRS (OR = 6.13; p < .001) and CFR (OR = 3.28; p < .001) were the only two independent predictors for decreased 6 MWTD in hypertensive patients. Importantly the ≥3 cutoff number of leads was found to be the best predictor of CFR < 2.0 in hypertensive patients.
CONCLUSION: FQRS is frequent and an independent predictor of reduced exercise tolerance in hypertensive patients. More so, it is significantly associated with decreased CFR and left ventricular diastolic dysfunction. In light of these findings, fragmented QRS might be considered a simple marker for risk stratification of hypertensive patients.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app