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Article: Subclinical left ventricular dysfunction revealed by circumferential 2D strain imaging in patients with coronary artery disease and fragmented QRS complex
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TitleSubclinical left ventricular dysfunction revealed by circumferential 2D strain imaging in patients with coronary artery disease and fragmented QRS complex
 
AuthorsYan, GH2 3
Wang, M1 3
Yiu, KH1 3
Lau, CP3
Zhi, G4
Lee, SWL3
Siu, CW1 3
Tse, HF1 3
 
KeywordsCoronary Artery Disease
Fragmented Qrs
Strain
Strain Rate
 
Issue Date2012
 
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal
 
CitationHeart Rhythm, 2012, v. 9 n. 6, p. 928-935 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.hrthm.2012.01.007
 
AbstractBackground: Fragmented QRS (fQRS) complexes on a routine 12-lead electrocardiogram were associated with adverse cardiac events, including sudden death in patients with coronary artery disease (CAD). Objective: To investigate the relationship between the fQRS complex and global and regional left ventricular (LV) functions in patients with CAD. Methods: The study consisted of 176 patients (68 ± 9 years; 145 [82%] men) with CAD with narrow QRS duration and preserved LV ejection fraction (>45%). All patients underwent detailed 2-dimensional speckle-tracking echocardiography to determine global and segmental (basal, middle, and apical) LV strains and strain rates and were prospectively followed-up in the outpatient clinic. Results: Fifty-five patients (31%) had fQRS complexes. Global, middle, and apical LV longitudinal, radial, and circumferential strains and strain rates were significantly lower in the fQRS group than in the non-fQRS group (all P <.05). Multivariate logistic regression analysis revealed that the fQRS complex was associated with decreased global circumferential strain (odds ratio 1.19; 95% confidence interval 1.06-1.33; P =.003) and multivessel disease (odds ratio 3.69; 95% confidence interval 1.35-10.08; P =.011). Kaplan-Meier analysis revealed that event-free survival for cardiac events was significantly lower in the fQRS group than in the non-fQRS group (P =.036). Conclusions: Our results demonstrated that the fQRS complex in patients with CAD with preserved LV ejection fraction was associated with subclinical global and regional LV dysfunctions as detected by 2-dimensional speckle-tracking imaging, and the results also predicted adverse cardiac events. © 2012 Heart Rhythm Society. All rights reserved.
 
ISSN1547-5271
2013 Impact Factor: 4.918
2013 SCImago Journal Rankings: 3.335
 
DOIhttp://dx.doi.org/10.1016/j.hrthm.2012.01.007
 
ISI Accession Number IDWOS:000304242900019
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorYan, GH
 
dc.contributor.authorWang, M
 
dc.contributor.authorYiu, KH
 
dc.contributor.authorLau, CP
 
dc.contributor.authorZhi, G
 
dc.contributor.authorLee, SWL
 
dc.contributor.authorSiu, CW
 
dc.contributor.authorTse, HF
 
dc.date.accessioned2012-09-05T05:32:24Z
 
dc.date.available2012-09-05T05:32:24Z
 
dc.date.issued2012
 
dc.description.abstractBackground: Fragmented QRS (fQRS) complexes on a routine 12-lead electrocardiogram were associated with adverse cardiac events, including sudden death in patients with coronary artery disease (CAD). Objective: To investigate the relationship between the fQRS complex and global and regional left ventricular (LV) functions in patients with CAD. Methods: The study consisted of 176 patients (68 ± 9 years; 145 [82%] men) with CAD with narrow QRS duration and preserved LV ejection fraction (>45%). All patients underwent detailed 2-dimensional speckle-tracking echocardiography to determine global and segmental (basal, middle, and apical) LV strains and strain rates and were prospectively followed-up in the outpatient clinic. Results: Fifty-five patients (31%) had fQRS complexes. Global, middle, and apical LV longitudinal, radial, and circumferential strains and strain rates were significantly lower in the fQRS group than in the non-fQRS group (all P <.05). Multivariate logistic regression analysis revealed that the fQRS complex was associated with decreased global circumferential strain (odds ratio 1.19; 95% confidence interval 1.06-1.33; P =.003) and multivessel disease (odds ratio 3.69; 95% confidence interval 1.35-10.08; P =.011). Kaplan-Meier analysis revealed that event-free survival for cardiac events was significantly lower in the fQRS group than in the non-fQRS group (P =.036). Conclusions: Our results demonstrated that the fQRS complex in patients with CAD with preserved LV ejection fraction was associated with subclinical global and regional LV dysfunctions as detected by 2-dimensional speckle-tracking imaging, and the results also predicted adverse cardiac events. © 2012 Heart Rhythm Society. All rights reserved.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationHeart Rhythm, 2012, v. 9 n. 6, p. 928-935 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.hrthm.2012.01.007
 
dc.identifier.doihttp://dx.doi.org/10.1016/j.hrthm.2012.01.007
 
dc.identifier.epage935
 
dc.identifier.hkuros218478
 
dc.identifier.isiWOS:000304242900019
 
dc.identifier.issn1547-5271
2013 Impact Factor: 4.918
2013 SCImago Journal Rankings: 3.335
 
dc.identifier.issue6
 
dc.identifier.pmid22245798
 
dc.identifier.scopuseid_2-s2.0-84862777690
 
dc.identifier.spage928
 
dc.identifier.urihttp://hdl.handle.net/10722/163501
 
dc.identifier.volume9
 
dc.languageeng
 
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal
 
dc.publisher.placeUnited States
 
dc.relation.ispartofHeart Rhythm
 
dc.relation.referencesReferences in Scopus
 
dc.subjectCoronary Artery Disease
 
dc.subjectFragmented Qrs
 
dc.subjectStrain
 
dc.subjectStrain Rate
 
dc.titleSubclinical left ventricular dysfunction revealed by circumferential 2D strain imaging in patients with coronary artery disease and fragmented QRS complex
 
dc.typeArticle
 
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<contributor.author>Wang, M</contributor.author>
<contributor.author>Yiu, KH</contributor.author>
<contributor.author>Lau, CP</contributor.author>
<contributor.author>Zhi, G</contributor.author>
<contributor.author>Lee, SWL</contributor.author>
<contributor.author>Siu, CW</contributor.author>
<contributor.author>Tse, HF</contributor.author>
<date.accessioned>2012-09-05T05:32:24Z</date.accessioned>
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<description.abstract>Background: Fragmented QRS (fQRS) complexes on a routine 12-lead electrocardiogram were associated with adverse cardiac events, including sudden death in patients with coronary artery disease (CAD). Objective: To investigate the relationship between the fQRS complex and global and regional left ventricular (LV) functions in patients with CAD. Methods: The study consisted of 176 patients (68 &#177; 9 years; 145 [82%] men) with CAD with narrow QRS duration and preserved LV ejection fraction (&gt;45%). All patients underwent detailed 2-dimensional speckle-tracking echocardiography to determine global and segmental (basal, middle, and apical) LV strains and strain rates and were prospectively followed-up in the outpatient clinic. Results: Fifty-five patients (31%) had fQRS complexes. Global, middle, and apical LV longitudinal, radial, and circumferential strains and strain rates were significantly lower in the fQRS group than in the non-fQRS group (all P &lt;.05). Multivariate logistic regression analysis revealed that the fQRS complex was associated with decreased global circumferential strain (odds ratio 1.19; 95% confidence interval 1.06-1.33; P =.003) and multivessel disease (odds ratio 3.69; 95% confidence interval 1.35-10.08; P =.011). Kaplan-Meier analysis revealed that event-free survival for cardiac events was significantly lower in the fQRS group than in the non-fQRS group (P =.036). Conclusions: Our results demonstrated that the fQRS complex in patients with CAD with preserved LV ejection fraction was associated with subclinical global and regional LV dysfunctions as detected by 2-dimensional speckle-tracking imaging, and the results also predicted adverse cardiac events. &#169; 2012 Heart Rhythm Society. All rights reserved.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong Li Ka Shing Faculty of Medicine
  2. Xiamen University
  3. The University of Hong Kong
  4. General Hospital of People's Liberation Army