The utility of fragmented QRS in association with strain echocardiography in predicting significant coronary artery stenosis

TL;DR

This study shows that combining fragmented QRS on ECG with reduced heart muscle strain can help identify significant coronary artery blockages.

Contribution

The study introduces a new method combining ECG and echocardiography to predict and locate significant coronary artery stenosis.

Findings

Patients with fQRS and significant CAD had significantly reduced myocardial strain compared to controls.

Combining fQRS and reduced strain improves prediction of coronary artery stenosis location and presence.

The method is effective in identifying arteries with more than 70% stenosis.

Abstract

Fragmented QRS (fQRS) on a 12-lead ECG indicates electrical conduction disruption due to various cardiac issues, including coronary artery disease (CAD). This study investigated whether combining fQRS and reduced myocardial strain could predict significant CAD.

We conducted a cross-sectional study on patients with fQRS on surface ECG who underwent coronary angiography. The left ventricular strain was assessed using 2D speckle-tracking echocardiography.

We enrolled 55 patients with fQRS and significant CAD (≥70% coronary artery stenosis) and 55 control patients (≤30% stenosis). The strain was significantly reduced in segments with fQRS and significant CAD compared with the control group.

In patients with CAD, the combination of fQRS in any ECG lead and reduced strain can predict the presence and location of a coronary artery with greater than 70% stenosis.

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