Association between fragmented QRS and left ventricular dysfunction in acromegaly patients

Abstract

Background:In acromegaly patients; it has been observed that heart failure may develop even in the absence of predisposing factors such as hypertension, diabetes mellitus, so a specific acromegalic cardiomyopathy has been suggested. We aimed to evaluate the fQRS frequency in acromegaly patients and the left ventricular (LV) functions of acromegaly patients with fQRS. Methods:Our study included 60 acromegalic patients. Each patient underwent conventional echocardiography and tissue Doppler imaging. The patients included were separated into two groups: those with (n:23) and without (n:37) fQRS. Results:Significant differences were identified between fQRS(+) and fQRS (-) groups with respect to disease duration (p < .001), Left ventricular end diastolic volume (EDV) (p < .001),Evelocity (p < .001),E\Aratio (p < .001),E' velocity (p < .001),E/E' ratio (p < .001), isovolumic relaxation time (IVRT) (p < .001), MPI (p < .001). Disease duration (odds ratio [OR]: 2.120 (1.023-1.703 95% confidence interval [CI]),p = .002),E' (OR:3.029 (1.013-1.703 95% CI)p = .004) and fQRS (OR:4.59 (1.94-10.87 95% CI),p = .001) were identified as the independent predictors of myocardial performance index (MPI). However, disease duration (OR:1.078 (1.030-1.128 95% CI),p = .001),E/E' (OR: 1.43 (1.22-1.97 95% CI),p = .001), IVRT (OR:1.65 (1.32-2.06 95% CI),p = .001) and MPI (OR:1.014 (1.004-1.024 95% CI),p = .002) were the independent predictors of fQRS. Conclusions:fQRS was frequent and an independent predictor of MPI that was independelty associated with LV dysfunction in patients with acromegaly. In light of these findings the presence of fQRS is thought to be an indicator of acromegalic CMP development.