PMID- 21962997
OWN - NLM
STAT- MEDLINE
DCOM- 20120207
LR  - 20220330
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 109
IP  - 1
DP  - 2012 Jan 1
TI  - Relation of fragmented QRS complex to right ventricular fibrosis detected by late 
      gadolinium enhancement cardiac magnetic resonance in adults with repaired 
      tetralogy of fallot.
PG  - 110-5
LID - 10.1016/j.amjcard.2011.07.070 [doi]
AB  - Fragmented QRS (fQRS) on 12-lead electrocardiography reflects conduction delay 
      caused by myocardial fibrosis and dysfunction. Ventricular fibrosis detected by 
      late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) is reportedly 
      correlated with worse clinical outcomes in adults with repaired tetralogy of 
      Fallot (TOF). The aim of this study was to assess whether the presence of fQRS is 
      associated with right ventricular (RV) fibrosis or dysfunction in this patient 
      group. In 37 consecutive patients (median age 30 years, median age at repair 6.6 
      years), the number of leads showing fQRS, defined as the presence of >2 notches 
      on the R/S wave in >/=2 contiguous leads, was counted. RV systolic function, 
      dilatation, and LGE score were measured using LGE CMR. Ventricular LGE was 
      observed mainly at the previous surgical sites: the RV outflow tract (33 of 37), 
      ventricular septal defect patch region (15 of 37), and RV anterior wall (11 of 
      37). Fragmented QRS was found mostly in the right and mid precordial leads. The 
      fQRS group (n = 20) demonstrated higher RV LGE scores (p <0.001) and lower RV 
      ejection fractions (p = 0.02) and a trend toward larger RV end-diastolic and 
      end-systolic volumes (p = 0.12 and p = 0.06, respectively) compared to the 
      non-fQRS group (n = 17). The number of electrocardiographic leads showing fQRS 
      was positively correlated with RV LGE score (r = 0.75, p <0.001). The presence of 
      fQRS remained independently associated with the presence of supramedian RV LGE 
      score, even after adjusting for relevant parameters. In conclusion, fQRS was 
      closely associated with more extensive RV fibrosis and dysfunction in adults with 
      repaired tetralogy of Fallot.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Park, Seung-Jung
AU  - Park SJ
AD  - Department of Internal Medicine, Cardiovascular Imaging Center, Sungkyunkwan 
      University School of Medicine, Seoul, Korea.
FAU - On, Young Keun
AU  - On YK
FAU - Kim, June Soo
AU  - Kim JS
FAU - Park, Seung Woo
AU  - Park SW
FAU - Yang, Ji-Hyuk
AU  - Yang JH
FAU - Jun, Tae-Gook
AU  - Jun TG
FAU - Kang, I-Seok
AU  - Kang IS
FAU - Lee, Heung Jae
AU  - Lee HJ
FAU - Choe, Yeon Hyeon
AU  - Choe YH
FAU - Huh, June
AU  - Huh J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20110929
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cardiac Surgical Procedures
MH  - Child
MH  - Contrast Media
MH  - Diagnosis, Differential
MH  - Disease Progression
MH  - *Electrocardiography
MH  - Female
MH  - Fibrosis/diagnosis/etiology
MH  - Follow-Up Studies
MH  - *Gadolinium DTPA
MH  - Heart Ventricles/*pathology/physiopathology
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Retrospective Studies
MH  - Tetralogy of Fallot/complications/diagnosis/*surgery
MH  - Time Factors
MH  - Ventricular Dysfunction, Right/*diagnosis/etiology/physiopathology
MH  - Ventricular Function, Right/*physiology
MH  - Young Adult
EDAT- 2011/10/04 06:00
MHDA- 2012/02/09 06:00
CRDT- 2011/10/04 06:00
PHST- 2011/06/17 00:00 [received]
PHST- 2011/07/29 00:00 [revised]
PHST- 2011/07/29 00:00 [accepted]
PHST- 2011/10/04 06:00 [entrez]
PHST- 2011/10/04 06:00 [pubmed]
PHST- 2012/02/09 06:00 [medline]
AID - S0002-9149(11)02559-8 [pii]
AID - 10.1016/j.amjcard.2011.07.070 [doi]
PST - ppublish
SO  - Am J Cardiol. 2012 Jan 1;109(1):110-5. doi: 10.1016/j.amjcard.2011.07.070. Epub 
      2011 Sep 29.