Clinical significance of fragmented QRS in relation to left ventricular mass and carotid intima-media thickness in hypertensive individuals

Mucahit Yetim; Macit Kalçık; Lütfü Bekar; Muhammet Cihat Çelik; Yusuf Karavelioğlu

doi:10.17826/cumj.1785525

Clinical significance of fragmented QRS in relation to left ventricular mass and carotid intima-media thickness in hypertensive individuals

Authors : Mucahit Yetim, Macit Kalçık, Lütfü Bekar, Muhammet Cihat Çelik, Yusuf Karavelioğlu

Pages : 1073-1083

Doi:10.17826/cumj.1785525

View : 41 | Download : 155

Publication Date : 2025-12-22

Article Type : Research Paper

Abstract :Purpose: Fragmented QRS (fQRS) is an electrocardiographic marker of depolarization abnormalities related to myocardial fibrosis. Although fQRS has been linked to adverse cardiovascular outcomes, its relationship with vascular remodeling in hypertension remains unclear. This study aimed to investigate the association between fQRS, left ventricular hypertrophy (LVH), and carotid artery disease in hypertensive patients. Materials and Methods: A total of 292 patients with essential hypertension were enrolled and stratified into two groups according to the presence (n = 128) or absence (n = 164) of fQRS on 12-lead electrocardiography. All participants underwent transthoracic echocardiography to determine left ventricular mass (LVM) and left ventricular mass index (LVMI), as well as carotid ultrasonography for measurement of carotid intima-media thickness (CIMT) and plaque detection. Results: Baseline demographic and laboratory parameters, including lipid profile and inflammatory markers, did not differ significantly between groups. However, patients with fQRS exhibited higher systolic and diastolic blood pressure, greater LVM and LVMI, and a markedly increased prevalence of LVH (60.9% vs. 14.6%). Carotid ultrasound revealed significantly higher CIMT values (Right: 0.87 vs. 0.71; Left: 0.86 vs. 0.70) and plaque burden (32.8% vs. 11%) in the fQRS group. Multivariable analysis identified right CIMT >0.72 mm, left CIMT >0.74 mm, LVM >145 g, LVMI >91 g/m², and carotid plaque presence as independent associates of fQRS. Conclusion: Fragmented QRS is strongly associated with both myocardial and vascular target-organ damage in hypertension. Its presence may serve as a non-invasive marker for identifying high-risk patients who warrant intensified cardiovascular risk assessment and management.
Keywords : Fragmente QRS, Hipertansiyon, Sol ventrikül hipertrofisi, Karotis intima-media kalınlığı, Karotis plak

ORIGINAL ARTICLE URL