The prognostic role of fragmented QRS complex in acute myocarditis

Yıl 2019, Cilt: 10 Sayı: 1, 62 - 67, 21.03.2019

Sefa Ünal , Samet Yilmaz , Çağrı Yayla , Mevlüt Serdar Kuyumcu , İlke Erbay Burak Açar , Mustafa Karanfil Ahmet Göktuğ Ertem , Koray Demirtaş , Ahmet Akdi , Sinan Aydoğdu

https://doi.org/10.18663/tjcl.516494

Öz

Aim:
Although
a fulminant course of the myocarditis is difficult to predict, it may lead to
acute heart failure and death. Previous studies have demonstrated that reduced
left ventricular systolic function and prolonged QRS duration can predict the
fulminant course. This study aimed to identify whether fragmented QRS complex
(fQRS) could also be predictive of fulminant disease in this population.

 

Material and Methods: We retrospectively included 156 patients diagnosed with acute
myocarditis. They were divided into the fulminant group (n = 18) and the
non-fulminant group (n = 138). Multivariate logistic regression analysis was
used to identify the independent factors predictive of fulminant disease.

 

Results: Fragmented
QRS developed in 11 (61%) in the fulminant group and only 10 patients (7%) in
the non-fulminant group (p <0.001). Patients with fulminant myocarditis had a higher mortality rate
than those with non-fulminant disease (44.6% vs. 0%, p < 0.001).
Multivariate analysis revealed that the presence of fQRS (p=0.019), longer
Tpe/qt ratio (p=0.022) and clinical heart failure (<0.001) were significant predictors associated with a fulminant course
of myocarditis.

 

Conclusion:
The presence of fQRS complex, as a simple and feasible
electrocardiographic marker, seems to be a novel predictor fulminant
myocarditis. This
simpleparameter may be used in identifying patients at high risk for fulminancy
and so early mechanical support could provide
improved patient outcomes.

Anahtar Kelimeler

Myocarditis, Fragmented QRS, Tp-e/QT ratio, Heart Failure

Akut miyokarditte fragmante QRS kompleksinin prognostik rolü

Öz

Amaç:
Miyokarditin fulminan seyrini tahmin etmek zor olsa da, akut kalp yetmezliği ve
ölüme neden olabilir. Önceki çalışmalar, sol ventrikül sistolik fonksiyonunun
azaldığını ve uzamış QRS süresinin fulminan seyrini öngörebileceğini
göstermiştir. Bu çalışma, fragmante QRS kompleksinin (fQRS) de bu
popülasyondaki fulminan hastalığın öngörüsü olup olmadığını belirlemeyi
amaçlamıştır.

Gereç ve Yöntemler:
Akut miyokardit tanısı almış 156 hastayı retrospektif olarak dahil ettik.
Hastalar fulminan (n = 18) ve fulminan olmayan gruba (n = 138) ayrıldı.
Fulminan hastalığı öngören bağımsız faktörleri tanımlamak için çok değişkenli
lojistik regresyon analizi kullanılmıştır.

Bulgular:
Fragmante QRS fulminan grupta 11 (% 61), fulminan olmayan grupta sadece 10
hasta (% 7) gelişti (p <0.001). Fulminan miyokardit hastaları fulminan
olmayan hastalardan daha yüksek mortalite oranına sahipti (% 44.6 vs.% 0, p
<0.001). Çok değişkenli analiz, fQRS (p = 0.019), daha uzun Tp-e / QT
oranının (p = 0.022) ve klinik kalp yetmezliğinin (<0.001) varlığında,
fulminan bir miyokardit seyri ile ilişkili önemli belirleyiciler olduğunu
ortaya koydu.

Sonuç:
Basit ve uygulanabilir bir elektrokardiyografik belirteç olarak fQRS
kompleksinin varlığı, fulminan miyokarditin yeni bir belirleyicisi olarak
görünmektedir. Bu basit parametre, uygunluk riski yüksek olan hastaları
belirlemek için kullanılabilir ve bu nedenle erken mekanik destek daha iyi
hasta sonuçları sağlayabilir.

Anahtar Kelimeler

Akut Miyokardit, Fragmante QRS, Tp-e / QT oranı, Kalp yetersizliği

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