Fragmented QRS, a strong predictor of mortality and major arrhythmic events in patients with nonischemic cardiomyopathy : A systematic review and meta-analysis

© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC..

Background and Aims: Fragmented QRS (fQRS), which is associated with rhythm disturbances, can predispose the heart to fatal ventricular arrhythmias. Recently, accumulating studies indicates that fQRS is associated with poor prognosis in various types of cardiomyopathies. Therefore, we assessed the association between fQRS with all-cause mortality and major arrhythmic events (MAEs) in patients with nonischemic cardiomyopathy, in this systematic review and meta-analysis study.

Methods: We performed a comprehensive search in databases of PubMed/Medline, EMBASE, and Web of Science from the beginning to December 31, 2022. Published observational studies (cohorts, case-control, or analytical cross-sectional studies) were included that report the prognostic value of fQRS in patients with different types of nonischemic cardiomyopathies for MAEs (sudden cardiac death, sudden cardiac arrest, sustained ventricular tachycardia [VT], ventricular fibrillation [VF], and appropriate shock) and all-cause mortality. We pooled risk ratios (RRs) through raw data and adjusted hazard ratios (aHRs) using "Comprehensive Meta-Analysis" software, Version 2.0.

Results: Nineteen cohort and three analytical cross-sectional studies were included in this meta-analysis involving a total of 4318 subjects with nonischemic cardiomyopathy (1279 with fQRS and 3039 without fQRS). FQRS was significantly associated with an increased risk of all-cause mortality in patients with nonischemic cardiomyopathy (pooled RR: 1.920; 95% confidence interval [CI]: 1.388-2.656, p < 0.0001/pooled HR: 1.729; 95% CI: 1.327-2.251, p < 0.0001). Also, the risk of developing MAEs in the presence of fQRS was significantly increased (pooled RR: 2.041; 95% CI: 1.644-2.533, p < 0.0001/pooled HR: 3.626; 95% CI: 2.119-6.204, p < 0.0001). In the subgroup analysis, the strongest association between fQRS presence and increased MAEs was observed in patients with hypertrophic cardiomyopathy (HCM) (pooled RR: 3.44; 95% CI: 2.07-5.71, p < 0.0001/pooled HR: 3.21; 95% CI: 2.04-5.06, p < 0.0001).

Conclusion: Fragmented QRS could be a prognostic marker for all-cause mortality and MAEs in patients with various types of nonischemic cardiomyopathies, particularly HCM.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:7

Enthalten in:

Health science reports - 7(2024), 2 vom: 15. Feb., Seite e1888

Sprache:

Englisch

Beteiligte Personen:

Zangiabadian, Moein [VerfasserIn]
Sharifian Ardestani, Mohammad [VerfasserIn]
Rezaee, Malihe [VerfasserIn]
Saberi Sharbabaki, Elahe [VerfasserIn]
Nikoohemmat, Mahdi [VerfasserIn]
Eslami, Mohammad [VerfasserIn]
Goudarzi, Kian [VerfasserIn]
Sanjari, Mojgan [VerfasserIn]
Namazi, Mohammad Hasan [VerfasserIn]
Akbarzadeh, Mohammad Ali [VerfasserIn]
Aletaha, Azadeh [VerfasserIn]

Links:

Volltext

Themen:

All‐cause mortality
Fragmented QRS
Journal Article
Major arrhythmic events
Meta‐analysis
Nonischemic cardiomyopathy
Systematic review

Anmerkungen:

Date Revised 16.02.2024

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.1002/hsr2.1888

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368475824