Relation between Fragmented Electrocardiogram and Myocardial Reserve in Patients with Cardiac Syndrome X.

Shehata, Islam Elsayed; Belgasem, Ashraf M. A.; Mahfouz, Ragab A.; Tawfik, Omar F.

Background: We hypothesized that fragmented QRS (fQRS) is an early marker of myocardial involvement in patients with cardiac syndrome X (CSX) which had updated term "Microvascular angina (MVA)". Therefore, we aimed to investigate the possible relationship between fQRS and myocardial reserve in patients with MVA. Patients and Methods: A comparative cross-section study was conducted on 89 patients with typical angina symptoms, positive exercise treadmill test, and normal coronary angiography. All patients were subjected to history taking, electrocardiogram, echocardiography, dobutamine stress echocardiography, coronary angiography and measurement of body mass index, blood pressure and serum lipid profile. Results: The prevalence of fQRS in patients with MVA was 61%; there were nonsignificant difference in baseline echocardiography left ventricular mass, dimensions, and ejection fraction (EF%) between patients with and without fQRS; on the other hand, patients with fQRS showed a significant decrease in myocardial reserve at dobutamine stress echocardiography, and significant decrease in values of stroke volume and EF in comparison with patients without fQRS, fQRS was inversely correlated with cardiac output, stroke volume, EF as well as cardiac reserve; furthermore, number of leads with fQRS had a significant positive correlation with degree of reduction in cardiac reserve. Conclusion: In MVA patients, fQRS was correlated with reduced cardiac reserve; it has an important clue for microvascular and cardiac contractile dysfunction in these patients. Further follow-up data should be done on a large scale to show how to follow and treat those patients.

Journal of Indian College of Cardiology, 2019, Vol 9, Issue 4, p198

1561-8811

Academic Journal

10.4103/JICC.JICC_51_19