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2019 Month : August Volume : 8 Issue : 34 Page : 2658-2661

An Investigation into the Relationship between N-Terminal Pro B-Type Natriuretic Peptide (NT-proBNP) and Fragmented QRS in Patients with Chronic Heart Failure.

Javad Ramezani1, Zahra Sharifi2, Shirin Sadat Ghiasi3, Majid Jalalyazdi4

Corresponding Author:
Majid Jalalyazdi
Department of Cardiology,
School of Medicine,
Mashhad University of Medical Sciences,
Mashhad, Iran.
E-mail: drmajidjalayazdi@yahoo.com

ABSTRACT

BACKGROUND

Heart failure is a clinical syndrome characterized by a constellation of symptoms and signs often caused by a structural and/or functional cardiac abnormality resulting in reduced cardiac output and/or elevated intracardiac pressures. Fragmented QRS (fQRS) complex is associated with fibrosis or myocardial scar in patients with structural heart disease. Patients, especially cardiologists, are particularly concerned about heart failure in people suffering from dyspnoea. The prevalence of this disease is rising in industrial countries. The relationship between NT-proBNP and fragmented QRS in patients with chronic heart failure was investigated in this study.

METHODS

The population included 42 patients suffering from chronic heart failure. fQRS was described as ≥1 additional deflection, including the peak of the R-wave or the nadir of S-wave, in at least two continuous leads. According to the absence of fQRS [fQRS (-)] or presence of fQRS (n= 22 and n= 20, respectively), the patients were assigned to two groups. The statistical package for social sciences (SPSS, version 22) was used to analyse the data. Furthermore, the normality of the data was investigated by the Shapiro-Wilk test. The chi-square test and independent t-test were used to compare the variables.

RESULTS

42 patients (18 women and 24 men) aged 54.78±6.43 years participated in this study. Given the fQRS at hospitalization, the patients were assigned to fQRS (–) (n= 20) and fQRS (+) (n= 22) groups. The results showed that NT-proBNP level was significantly lower in fQRS (-) group (p < 0.001), compared to fQRS (+) group. There was a significant difference between the two groups in terms of NYHA, blood pressure, hypertension, diabetes and hyperlipidaemia. The groups were compared in terms of demographic characteristics, angiography including hyperlipidaemia, and history of cardiovascular diseases. The fQRS (+) group exhibited a higher proportion of hyperlipidaemia (63.40%), troponin I (34.33 ± 21.87) and NT-proBNP (242.34 ± 42.65) than the fQRS (-) group.

CONCLUSIONS

The results showed a significant relationship between fQRS and the higher levels of NT-proBNP. The fQRS was associated with increased NT-proBNP and pronounced LV end-diastolic pressure in heart failure patients.

KEY WORDS

Heart Failure, NT-proBNP, Fragmented QRS

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