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.

Keywords: Disfunção miocárdica; Epicardial adipose tissue; Fragmented QRS; Healthy; Myocardial dysfunction; QRS fragmentados; Saudável; Tecido adiposo epicárdico.