QRS micro-fragmentation as a mortality predictor
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F22%3A00076407" target="_blank" >RIV/65269705:_____/22:00076407 - isvavai.cz</a>
Alternative codes found
RIV/00216224:14110/22:00127066
Result on the web
<a href="https://academic.oup.com/eurheartj/article/43/40/4177/6533247" target="_blank" >https://academic.oup.com/eurheartj/article/43/40/4177/6533247</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1093/eurheartj/ehac085" target="_blank" >10.1093/eurheartj/ehac085</a>
Alternative languages
Result language
angličtina
Original language name
QRS micro-fragmentation as a mortality predictor
Original language description
Aims Fragmented QRS complex with visible notching on standard 12-lead electrocardiogram (ECG) is understood to represent depolarization abnormalities and to signify risk of cardiac events. Depolarization abnormalities with similar prognostic implications likely exist beyond visual recognition but no technology is presently suitable for quantification of such invisible ECG abnormalities. We present such a technology. Methods and results A signal processing method projects all ECG leads of the QRS complex into optimized three perpendicular dimensions, reconstructs the ECG back from this three-dimensional projection, and quantifies the difference (QRS 'micro'-fragmentation, QRS-mu f) between the original and reconstructed signals. QRS 'micro'-fragmentation was assessed in three different populations: cardiac patients with automatic implantable cardioverter-defibrillators, cardiac patients with severe abnormalities, and general public. The predictive value of QRS-mu f for mortality was investigated both univariably and in multivariable comparisons with other risk factors including visible QRS 'macro'-fragmentation, QRS-Mf. The analysis was made in a total of 7779 subjects of whom 504 have not survived the first 5 years of follow-up. In all three populations, QRS-mu f was strongly predictive of survival (P < 0.001 univariably, and P < 0.001 to P = 0.024 in multivariable regression analyses). A similar strong association with outcome was found when dichotomizing QRS-mu f prospectively at 3.5%. When QRS-mu f was used in multivariable analyses, QRS-Mf and QRS duration lost their predictive value. Conclusion In three populations with different clinical characteristics, QRS-mu f was a powerful mortality risk factor independent of several previously established risk indices. Electrophysiologic abnormalities that contribute to increased QRS-mu f values are likely responsible for the predictive power of visible QRS-Mf. Key question The cardiac risk associated with visually diagnosed QRS fragmentation suggests that important QRS abnormalities might exist below the resolution of visual detection. Nevertheless, at present, little possibility exists to detect 'invisible' abnormalities of myocardial depolarization. Key finding QRS 'micro-fragmentation', QRS- analysis quantifies 'invisible' abnormalities of myocardial depolarization. It was found to independently predict death in three different populations of a total of 7779 subjects of whom 504 have not survived the first 5 years of follow-up. Take-home message QRS-mu f is a strong predictor of worsened survival. It can be assessed in standard short-term 12-lead electrocardiograms.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2022
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
European Heart Journal
ISSN
0195-668X
e-ISSN
1522-9645
Volume of the periodical
43
Issue of the periodical within the volume
40
Country of publishing house
GB - UNITED KINGDOM
Number of pages
15
Pages from-to
4177-4191
UT code for WoS article
000758231400001
EID of the result in the Scopus database
2-s2.0-85138245396