PDF(Pubmed)
Abstract：
Introduction Hypertension is a leading risk factor for the development of cardiovascular and metabolic derangements. In patients with metabolic syndrome (MetS), hypertension is one of the cornerstones showing high variability which is detected in ambulatory blood pressure monitoring. Fragmented ventricular complexes on ECG are seen as hypertensives and are a viable and easy measure of myocardial fibrosis even in the absence of obvious hypertrophy. Aim The present study was undertaken to study the blood pressure variability in patients of MetS with fragmented QRS (fQRS) versus normal ventricular complexes (QRS). Results Out of 100 patients, 22 (22%) had fQRS complexes. Hypertension and diabetes were the most prevalent associated in both groups but a difference was seen with coronary artery disease, which was significantly associated in the fQRS group (8.97% vs 95.45%, p<0.001) as compared to the non-fQRS group. Significant differences were observed in waist circumference (p=0.019), triglyceride (p=0.006) and left ventricular ejection fraction (p<0.001) between the two groups. There was a marked difference (p<0.05) between heart rate variability during day and night time between normal and fQRS sub-groups, being higher in the latter. A similar pattern of change was observed for systolic and diastolic blood pressures and associated dipping. Conclusion Significant differences exist between heart rate and blood pressure changes in patients with fQRS of MetS, thus making fQRS a potent indicator of cardiovascular status.
摘要：
导言高血压是心血管和代谢紊乱发展的主要危险因素。在代谢综合征（MetS）患者中，高血压是在动态血压监测中发现的高变异性的基石之一。心电图上的碎裂心室复合物被视为高血压，即使在没有明显肥大的情况下，也是心肌纤维化的可行且简便的测量方法。目的本研究旨在研究具有碎裂QRS（fQRS）与正常心室复合体（QRS）的MetS患者的血压变异性。结果100例患者中,22(22%)有fQRS复合物。高血压和糖尿病是两组中最普遍的相关性，但冠状动脉疾病有差异。在fQRS组中显著相关(8.97%vs95.45%，p<0.001)与非fQRS组相比。腰围有显著差异(p=0.019),两组之间的甘油三酯（p=0.006）和左心室射血分数（p<0.001）。正常和fQRS亚组白天和夜间的心率变异性之间存在显着差异（p<0.05），后者更高。收缩压和舒张压以及相关的浸渍观察到类似的变化模式。结论MetS患者fQRS的心率和血压变化存在显著差异,因此使fQRS成为心血管状态的有效指标。
