RELATION BETWEEN FRAGMENTED QRS COMPLEX AND ARTERIAL COMPLIANCE IN ASYMPTOMATIC HYPERTENSIVE PATIENTS

Öz

Objective: Decreased arterial compliance is among the earliest detectable findings of adverse structural and functional changes in the vessel wall and it results in stiffened arteries. The goal of this study was to explore the relationship between fragmented QRS in electocardiogram and arterial compliance.

Material and Methods: Eighty asymptomatic hypertensive patients with fragmented QRS (40 male, mean age: 58±8/years) and 80 age-gender matched control subjects without fragmented QRS (39 male, mean age: 57±9/years) were enrolled. Arterial compliance was calculated as stroke volume to pulse pressure ratio and adjusted to body surface area to calculate the stroke volume to pulse pressure index. The fragmented QRS complexes were investigated in the 12-lead electrocardiogram.

Results: Patients wih fragmented QRS had significantly lower arterial compliance (0.71±0.29 mL/m2/mmHg versus 0.93±0.32 mL/m2/mmHg; p<0.001). A univariate analysis showed a significant correlation between decreased arterial compliance and fragmented QRS, age, and calcium channel blocker use. Multivariable analysis demonstrated age (95%CI): 0697-0.830; p<0.001) and fragmented QRS (95%CI): 0.06-0.536; p=0.002) as independent determinants of reduced arterial compliance.

Conclusion: The avaliability of fragmented QRS in electrocardiogram may have significant predictive information of arterial compliance in hypertensive subjects.

Anahtar Kelimeler

• Arterial Compliance
• Fragmented QRS
• Hypertension

Asemptomatik Hipertansif Hastalarda Parçalanmış QRS Kompleksi ile Arteryel Komplians Arasındaki İlişki

Öz

Amaç: Azalmış arteryel komplians, damar duvarındaki olumsuz yapısal ve fonksiyonel değişikliklerin en erken tespit edilebilen bulgusudur ve ilerleyen zamanda damar sertliği ile sonuçlanır. Bu çalışmanın amacı, elektrokardiyogramdaki parçalanmış QRS ile arteryel uyum arasındaki ilişkiyi araştırmaktır.

Gereç ve Yöntemler: Parçalanmış QRS’li 80 asemptomatik hipertansif hasta (40 erkek, ortalama yaş: 58±8/yıl) ve parçalanmış QRS’siz 80 yaş-cinsiyet eşleştirilmiş kontrol deneği (39 erkek, ortalama yaş: 57±9/yıl) çalışmaya kaydedildi. Arteryel komplians, vuruş hacmi/nabız basıncı oranı olarak hesaplandı ve vuruş hacmi/nabız basıncı indeksini hesaplamak için vücut yüzey alanına göre ayarlandı. Parçalanmış QRS kompleksleri 12 kanallı elektrokardiyogramda incelendi.

Bulgular: Parçalanmış QRS’li hastalar anlamlı olarak daha düşük arteryel kompliansa sahipti (0.71±0.29 mL/m2/mmHg’ye karşı 0.93±032 mL/m2/mmHg; p<0.001). Tek değişkenli analiz, azalmış arteryel komplians ile parçalanmış QRS, yaş ve kalsiyum kanal bloker kullanımı arasında anlamlı bir korelasyon gösterdi. Çoklu ikili lojistik regresyon analizi, azalmış arteryel kompliansın bağımsız belirleyicileri olarak yaşı (%95CI): 0697-0.830; p <0.001) ve parçalanmış QRS’i (%95CI): 0.06-0.536; p=0.002) göstermiştir.

Sonuç: Parçalanmış QRS’in elektrokardiyogramda bulunması, hipertansif hastalarda arteryel komplians ile ilgili önemli prediktif bilgi sağlayabilir.

Anahtar Kelimeler

• Arteryel Komplians
• Parçalanmış QRS
• Hipertansiyon

Kaynakça

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