Fragmented Ventricular Complexes and Blood Pressure Variability Assessed by Ambulatory Blood Pressure Monitoring in Patients With Metabolic Syndrome

TL;DR

This study shows that fragmented ventricular complexes on ECG are linked to greater heart rate and blood pressure variability in patients with metabolic syndrome.

Contribution

The study identifies fQRS as a novel indicator of cardiovascular risk in metabolic syndrome patients.

Findings

Patients with fQRS had significantly higher rates of coronary artery disease compared to those without fQRS.

Heart rate variability and blood pressure dipping were more pronounced in the fQRS group during day and night.

fQRS was associated with higher waist circumference and triglyceride levels in metabolic syndrome patients.

Abstract

Introduction

Hypertension is a leading risk factor for the development of cardiovascular and metabolic derangements. In patients with metabolic syndrome (MetS), hypertension is one of the cornerstones showing high variability which is detected in ambulatory blood pressure monitoring. Fragmented ventricular complexes on ECG are seen as hypertensives and are a viable and easy measure of myocardial fibrosis even in the absence of obvious hypertrophy.

Aim

The present study was undertaken to study the blood pressure variability in patients of MetS with fragmented QRS (fQRS) versus normal ventricular complexes (QRS).

Results

Out of 100 patients, 22 (22%) had fQRS complexes. Hypertension and diabetes were the most prevalent associated in both groups but a difference was seen with coronary artery disease, which was significantly associated in the fQRS group (8.97% vs 95.45%, p<0.001) as compared to the non-fQRS group. Significant differences were observed in waist circumference (p=0.019), triglyceride (p=0.006) and left ventricular ejection fraction (p<0.001) between the two groups. There was a marked difference (p<0.05) between heart rate variability during day and night time between normal and fQRS sub-groups, being higher in the latter. A similar pattern of change was observed for systolic and diastolic blood pressures and associated dipping.

Conclusion

Significant differences exist between heart rate and blood pressure changes in patients with fQRS of MetS, thus making fQRS a potent indicator of cardiovascular status.