- Oral presentation
- Open Access
Fragmented QRS complex and late gadolinium enhancement characterization of unrecognized myocardial scar provided complementary prognosis of cardiac death in patients with suspected coronary artery disease
© Hsiao et al; licensee BioMed Central Ltd. 2010
- Published: 21 January 2010
- Coronary Artery Disease
- Leave Ventricular Ejection Fraction
- Cardiovascular Magnetic Resonance
- Cardiac Death
- Late Gadolinium Enhancement
Fragmentation of the QRS complex (FQRS) on the resting electrocardiogram has been shown to be associated with post-infarct arrhythmogenesis and increased incidence of hard cardiac events. Late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) imaging can detect subendocardial unrecognized myocardial infarction which has been shown to indicate high risk for cardiac death.
This study sought to determine if FQRS and evidence of unrecognized myocardial scar by LGE, provide similar or incremental prognostic information in patients with suspected but no prior history of coronary artery disease (CAD).
The study was conducted on 331 patients (176 men and 155 women) referred for CMR assessment for evidence of CAD. Electrocardiograms were performed, on average, 1.6 ± 5 days before the CMR exam. FQRS was assessed according to established criteria. The patients were followed for a median duration of 3.27 years to monitor cardiac events.
Hazard ratio for cardiac death by univariable analysis
In patients with clinical suspicion and risk factors for CAD, FQRS and unrecognized myocardial scar detected by LGE provide robust and complementary prognosis to cardiac death. Incorporation of these non-invasive techniques in risk stratification algorithms warrants further prospective study.
This article is published under license to BioMed Central Ltd.