THE ASSOCIATION BETWEEN FRAGMENTED QRS ON ELECTROCARDIOGRAPHY AND BLOOD PRESSURE PATTERN IN PATIENTS WITH HYPERTENSION

Yıl 2019, , 63 - 68, 29.04.2019

Hasan Kadı , Eyüp Avcı

https://doi.org/10.18229/kocatepetip.434943

Öz

OBJECTIVE: Fragmented QRS (fQRS) complexes on electrocardiography (ECG) signify areal scar and fibrosis in the myocardium. Our aim was to investigate association between fragmented QRS and blood pressure pattern in hypertensive patients.

MATERIAL AND METHODS: Patients underwent ambulatory blood pressure were studied retrospectively. Patients whose systolic blood pressure was 10-20% lower during the night when compared to the day were grouped as “dipping group”, while those who had a decrease less than 10% during the night were grouped as “non-dipping group”. The fQRS was defined as the presence of a second R wave, notching of R or S wave or fragmentation in two contiguous leads on ECG corresponding to epicardial major coronary artery region.

RESULTS: The dipping group had 98 patients, while the non-dipping group had 89 patients. The groups were similar in terms of age, sex, body mass index, lipid profile and antihypertensive drugs. The fQRS was observed in 14 patients in the dipper group and 27 patients in the non-dipping group (p=0.008). The fQRS on ECG was found to be an independent predictor of non-dipping blood pressure pattern (p=0.046, odds ratio=2.27).

CONCLUSIONS: The presence of fQRS was more than in hypertensives with non-dipping pattern compared with dipping pattern and this variable was a predictor of non-dipping pattern.

Anahtar Kelimeler

Blood Pressure Monitoring, electrocardiography, hypertension, fragmented QRS

Hipertansiyonu Olan Hastalarda Kan Basıncı Paterni ve EKG'de fragmante QRS arasındaki ilişki

Öz

AMAÇ: Fragmante QRS (FQRS) kompleksleri bölgesel mi-yokardiyal fibrozisi gösterir ve artmış kardiyovasküler mortalite ve morbidite ile ilişkilidir. Hipertansiflerde fQRS ve kan basıncı paterni arasındaki ilişkiyi araştıran bir ça-lışma yoktur. Bu çalışmanın amacı hipertansiflerde kan basıncı paterni ve fQRS arasındaki ilişkiyi araştırmaktır.

GEREÇ VE YÖNTEM: Kliniğimizde ambulatuvar kan basıncı izlemi yapılmış olan hastalar geriye dönük olarak incelendi. Gündüz değerlerine göre gece sistolik kan basıncının %10-20 düşmesi “dipping patern”, bu düşüşün olmaması ise “non-dipping patern” olarak gruplandırıldı. fQRS major koroner arter sulama bölgesi ile uyumlu ardışık iki derivasyonda, ilave bir R dalgasının varlığı, R/S dalgasının çentiklenmesi veya fragmantasyonu olarak tanımlandı.

BULGULAR: Dipping grubunda 98 hasta, non-dipping grubunda ise 89 hasta vardı. Her iki grup yaş, cinsiyet, beden kitle indeksi, lipit profili ve antihipertansif ilaç kullanımı yönünden benzerdi. EKG’de fQRS varlığı dipper grubunda 14 hastada (%14), non-dipper grubunda ise 27 hastada (%30) mevuttu (p=0.008). EGG’de fQRS varlığı non-dipper kan basıncı paterninin bir öngördürücüsüydü (p=0.046, odds oranı=2.27, %95 güven aralığı= 1.04-6.37).

SONUÇ: EKG’de fQRS varlığı non-dipper kan basıncı paternine sahip hastalarda daha fazla bulundu. Ayrıca, bu değişken non-dipper paterninin öngördürücüsüydü.

Anahtar Kelimeler

Ambulatuvar Kan basıncı izlemi, Kan Basıncı paterni, Fragmante QRS

Kaynakça

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