Relationship between QRS characteristics and delayed-enhancement cardiac magnetic resonance in patients with ischemic cardiomyopathy

Gaston A. Rodriguez-Granillo; Carlos Ingino; Carolina Parada-Villavicencio; Pedro Lylyk

doi:10.1016/j.artres.2014.04.002

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Volume 8, Issue 3, September 2014, Pages 88 - 97

Relationship between QRS characteristics and delayed-enhancement cardiac magnetic resonance in patients with ischemic cardiomyopathy

Authors

Gaston A. Rodriguez-Granillo^a^{, b}^{, c}^{, *}, Carlos Ingino^a, Carolina Parada-Villavicencio^d, Pedro Lylyk^e

^aDepartment of Cardiology, ENERI-Clínica La Sagrada Familia, Buenos Aires, Argentina

^bOtamendi Hospital, Buenos Aires, Argentina

^cConsejo de Investigaciones Científicas y Técnicas (CONICET), Argentina

^dDepartment of Radiology, ENERI-Clínica La Sagrada Familia, Buenos Aires, Argentina

^eDepartment of Interventional Radiology, ENERI-Clínica La Sagrada Familia, Buenos Aires, Argentina

^*Corresponding author. ENERI-Clínica La Sagrada Familia, José Hernández 1642, C1426EOB Buenos Aires, Argentina. Tel./fax: +54 11 63437800. E-mail address: grodriguezgranillo@gmail.com (G.A. Rodriguez-Granillo).

Corresponding Author

Gaston A. Rodriguez-Granillo

Received 7 February 2014, Revised 26 March 2014, Accepted 2 April 2014, Available Online 19 May 2014.

DOI: 10.1016/j.artres.2014.04.002 How to use a DOI?
Keywords: Myocardial infarction; Non-invasive imaging; Fibrosis; Depolarization; Q wave; Fragmentation
Abstract: Background: We explored the relationship between QRS characteristics and myocardial phenotype by delayed-enhancement cardiac magnetic resonance (DE-CMR) in patients with coronary heart disease (CHD).

Methods and results: Eighty five consecutive patients with CHD that were referred for DE-CMR evaluation constituted the study population. Of a total of 1445 left ventricular (LV) segments evaluated, 346 (23.9%) segments had fibrosis.

Compared to patients without pathological Q waves, patients with pathological Q waves showed a higher number of segments with fibrosis (5.9 ± 3.1 vs. 2.7 ± 2.8, p < 0.001), and lower left ventricular ejection fraction (LVEF) (42.9 ± 13.6% vs. 51.8 ± 18.3, p = 0.01); whereas no significant differences were observed regarding LV size.

When discriminated in according to the QRS duration tertiles, no significant differences were observed regarding the number of segments with fibrosis (p = 0.34), whereas the highest QRS tertile was related to the presence of a low LVEF (p = 0.005) and larger LV size (p = 0.01). QRS fragmentation (fQRS), defined as the presence of an R′ or notching in the nadir of the R wave or the S wave, or the presence of >1 R′ in 2 contiguous leads, was significantly related to LV size (LV end diastolic volume 153.6 ± 81.6 ml, vs. 111.5 ± 41.4 ml, p = 0.003), function (LVEF 43.2 ± 15.9% vs. 53.6 ± 16.3%, p = 0.005), and extent of fibrosis (5.1 ± 3.4 segments vs. 3.2 ± 3.1 segments, p = 0.01).

Conclusions: In the present study, fQRS was the only QRS-derived variable systematically and more closely related to LV size, LV systolic function, and to the presence and extent of fibrosis.
Open Access: This is an open access article distributed under the CC BY-NC license.

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Journal: Artery Research
Volume-Issue: 8 - 3
Pages: 88 - 97
Publication Date: 2014/05/19
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2014.04.002 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

TY  - JOUR
AU  - Gaston A. Rodriguez-Granillo
AU  - Carlos Ingino
AU  - Carolina Parada-Villavicencio
AU  - Pedro Lylyk
PY  - 2014
DA  - 2014/05/19
TI  - Relationship between QRS characteristics and delayed-enhancement cardiac magnetic resonance in patients with ischemic cardiomyopathy
JO  - Artery Research
SP  - 88
EP  - 97
VL  - 8
IS  - 3
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2014.04.002
DO  - 10.1016/j.artres.2014.04.002
ID  - Rodriguez-Granillo2014
ER  -

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