The relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major

Eyup Buyukkaya, Mehmet Fatih Karakas, Mustafa Kurt, Perihan Bilen, Fatih Yalcin, Murat Celik, Rami Helvaci, Hasan Kaya, Filiz Ertekin, Erdogan Sökmen, Nihat Sen, Adnan Burak Akcay

Research output: Contribution to journalArticle

Abstract

Purpose: The most important complication encountered in patients with b-thalassaemia major is degenerative fibrosis developing as a result of iron accumulation in myocardial tissue. Dysfunction pursues this accumulation. Recently, presence of fragmented QRS (fQRS) in ECG has been regarded as a predictor of myocardial fibrosis. We aimed in our study to investigate the frequency with which fQRS develops in patients with b-thalassaemia major and to disclose the correlation between fQRS frequency and Doppler-derived indices. Methods: The patients with b-thalassaemia major (n=66; mean age: 23±6 years) and healthy controls (n=30; mean age: 23±4 years) were included. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings. 2D, M-mode, conventional Doppler, tissue Doppler echocardiography parameters were assessed. Mean serum ferritin levels over past 5 years were also calculated. Results: When compared to those in control group, fQRS was more frequent in bthalassaemia major group, indicating statistical significance (p = 0.001). While E/Em and ferritin level exhibited statistically significant increase in thalassaemia patients with fQRS (p <0.05), the mean Em and Sm values were found to be significantly low (p <0.05). Conclusions: fQRS was frequently observed in the patients with b-thalassaemia major, which was of statistical significance. Tissue Doppler-derived diastolic and systolic indices in thalassaemia cases with fQRS showed statistically significant impairment compared to those without fQRS. In conclusion, fQRS may represent a novel noninvasive marker for cardiac involvement in patients with b-thalassaemia major.

Original languageEnglish (US)
JournalClinical and Investigative Medicine
Volume35
Issue number5
StatePublished - 2012
Externally publishedYes

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beta-Thalassemia
Thalassemia
Ferritins
Electrocardiography
Fibrosis
Doppler Echocardiography
Iron
Control Groups
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Buyukkaya, E., Karakas, M. F., Kurt, M., Bilen, P., Yalcin, F., Celik, M., ... Akcay, A. B. (2012). The relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major. Clinical and Investigative Medicine, 35(5).

The relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major. / Buyukkaya, Eyup; Karakas, Mehmet Fatih; Kurt, Mustafa; Bilen, Perihan; Yalcin, Fatih; Celik, Murat; Helvaci, Rami; Kaya, Hasan; Ertekin, Filiz; Sökmen, Erdogan; Sen, Nihat; Akcay, Adnan Burak.

In: Clinical and Investigative Medicine, Vol. 35, No. 5, 2012.

Research output: Contribution to journalArticle

Buyukkaya, E, Karakas, MF, Kurt, M, Bilen, P, Yalcin, F, Celik, M, Helvaci, R, Kaya, H, Ertekin, F, Sökmen, E, Sen, N & Akcay, AB 2012, 'The relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major', Clinical and Investigative Medicine, vol. 35, no. 5.
Buyukkaya, Eyup ; Karakas, Mehmet Fatih ; Kurt, Mustafa ; Bilen, Perihan ; Yalcin, Fatih ; Celik, Murat ; Helvaci, Rami ; Kaya, Hasan ; Ertekin, Filiz ; Sökmen, Erdogan ; Sen, Nihat ; Akcay, Adnan Burak. / The relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major. In: Clinical and Investigative Medicine. 2012 ; Vol. 35, No. 5.
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T1 - The relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major

AU - Buyukkaya, Eyup

AU - Karakas, Mehmet Fatih

AU - Kurt, Mustafa

AU - Bilen, Perihan

AU - Yalcin, Fatih

AU - Celik, Murat

AU - Helvaci, Rami

AU - Kaya, Hasan

AU - Ertekin, Filiz

AU - Sökmen, Erdogan

AU - Sen, Nihat

AU - Akcay, Adnan Burak

PY - 2012

Y1 - 2012

N2 - Purpose: The most important complication encountered in patients with b-thalassaemia major is degenerative fibrosis developing as a result of iron accumulation in myocardial tissue. Dysfunction pursues this accumulation. Recently, presence of fragmented QRS (fQRS) in ECG has been regarded as a predictor of myocardial fibrosis. We aimed in our study to investigate the frequency with which fQRS develops in patients with b-thalassaemia major and to disclose the correlation between fQRS frequency and Doppler-derived indices. Methods: The patients with b-thalassaemia major (n=66; mean age: 23±6 years) and healthy controls (n=30; mean age: 23±4 years) were included. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings. 2D, M-mode, conventional Doppler, tissue Doppler echocardiography parameters were assessed. Mean serum ferritin levels over past 5 years were also calculated. Results: When compared to those in control group, fQRS was more frequent in bthalassaemia major group, indicating statistical significance (p = 0.001). While E/Em and ferritin level exhibited statistically significant increase in thalassaemia patients with fQRS (p <0.05), the mean Em and Sm values were found to be significantly low (p <0.05). Conclusions: fQRS was frequently observed in the patients with b-thalassaemia major, which was of statistical significance. Tissue Doppler-derived diastolic and systolic indices in thalassaemia cases with fQRS showed statistically significant impairment compared to those without fQRS. In conclusion, fQRS may represent a novel noninvasive marker for cardiac involvement in patients with b-thalassaemia major.

AB - Purpose: The most important complication encountered in patients with b-thalassaemia major is degenerative fibrosis developing as a result of iron accumulation in myocardial tissue. Dysfunction pursues this accumulation. Recently, presence of fragmented QRS (fQRS) in ECG has been regarded as a predictor of myocardial fibrosis. We aimed in our study to investigate the frequency with which fQRS develops in patients with b-thalassaemia major and to disclose the correlation between fQRS frequency and Doppler-derived indices. Methods: The patients with b-thalassaemia major (n=66; mean age: 23±6 years) and healthy controls (n=30; mean age: 23±4 years) were included. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings. 2D, M-mode, conventional Doppler, tissue Doppler echocardiography parameters were assessed. Mean serum ferritin levels over past 5 years were also calculated. Results: When compared to those in control group, fQRS was more frequent in bthalassaemia major group, indicating statistical significance (p = 0.001). While E/Em and ferritin level exhibited statistically significant increase in thalassaemia patients with fQRS (p <0.05), the mean Em and Sm values were found to be significantly low (p <0.05). Conclusions: fQRS was frequently observed in the patients with b-thalassaemia major, which was of statistical significance. Tissue Doppler-derived diastolic and systolic indices in thalassaemia cases with fQRS showed statistically significant impairment compared to those without fQRS. In conclusion, fQRS may represent a novel noninvasive marker for cardiac involvement in patients with b-thalassaemia major.

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