QRS Fragmentation and Sudden Cardiac Death in the Obese and Overweight

Autor: Candice Kim, Lin Zhang, Kumar Narayanan, Audrey Uy-Evanado, Sumeet S. Chugh, Jonathan Jui, Kyndaron Reinier, Carmen Teodorescu, Karen Gunson, Zhi Jie Zheng
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Male
obesity
Time Factors
030204 cardiovascular system & hematology
Overweight
Ventricular Function
Left
Sudden cardiac death
Electrocardiography
Oregon
0302 clinical medicine
Risk Factors
Odds Ratio
Prevalence
Medicine
Arrhythmia and Electrophysiology
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Original Research
education.field_of_study
Ejection fraction
Middle Aged
Prognosis
Cardiology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
QRS fragmentation
Population
sudden cardiac death
03 medical and health sciences
QRS complex
Heart Conduction System
Predictive Value of Tests
Internal medicine
Humans
cardiovascular diseases
education
Aged
Chi-Square Distribution
business.industry
ECG
Case-control study
Arrhythmias
Cardiac
Stroke Volume
Odds ratio
medicine.disease
Death
Sudden
Cardiac
Logistic Models
Case-Control Studies
Multivariate Analysis
business
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
Popis: Background Obesity has been associated with significantly greater risk of sudden cardiac death ( SCD ); however, identifying the obese patient at highest risk remains a challenge. We evaluated the association between QRS fragmentation on the 12‐lead electrocardiogram and SCD , in obese/overweight subjects. Methods and Results In the ongoing prospective, community‐based Oregon Sudden Unexpected Death Study (population approximately 1 million), we performed a case‐control analysis, comparing obese/overweight SCD victims with obese/overweight controls from the same geographic region. Archived ECG s prior and unrelated to the SCD event were used for cases and all ECG measurements were assessed in blinded fashion. Fragmentation was defined as the presence of RSR ’ patterns and/or notching of the R/S wave in at least 2 contiguous leads. Analysis was limited to ECG s with QRS duration P =0.06). Lateral fragmentation was significantly more frequent in cases (8.1% versus 2.5%; P P =0.02). In multivariable analysis with consideration of established SCD risk factors, lateral fragmentation was significantly associated with SCD ( OR 2.84; 95% CI 1.01 to 8.02; P =0.05). Conclusion QRS fragmentation, especially in the lateral territory is a potential risk marker for SCD independent of the ejection fraction, among obese/overweight subjects in the general population.
Databáze: OpenAIRE
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