The presence of fragmented QRS is associated with increased epicardial adipose tissue and subclinical myocardial dysfunction in healthy individuals

Abstract

Aim: The aim of this study was to measure epicardial adipose tissue (EAT) and to assess left ventricular (LV) systolic and diastolic function in a healthy population grouped according to the presence of fragmented QRS (fQRS).

Methods: In this prospective case-control study, the study population consisted of 308 healthy individuals who were divided into two groups according to the existence of fQRS: 180 fQRS(+) individuals (with fQRS), and 128 age-and gender-matched fQRS(-) individuals (without fQRS). These individuals were assessed for EAT thickness and subclinical myocardial dysfunction using transthoracic echocardiography including strain imaging.

Results: The baseline clinical characteristics were similar between groups. EAT thickness was significantly increased in fQRS(+) individuals (0.59 vs. 0.44 mm, p< 0.001). LV global longitudinal strain, reflecting systolic function (19.62 +/- 3.05 vs. 20.95 +/- 2.36, p< 0.001) and E/A ratio, reflecting diastolic function (0.95 +/- 0.30 vs. 1.10 +/- 0.37, p< 0.001), were decreased, revealing subclinical myocardial dysfunction, in fQRS(+) individuals.

Conclusions: The presence of fQRS on the admission ECG is associated with increased EAT and pronounced subclinical LV systolic and diastolic dysfunction in a healthy population. Further studies with larger patient groups are needed to clarify the exact pathophysiological mechanisms underlying these findings in healthy populations. (C) 2018 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.