1. Fragmented QRS on 12-Lead Electrocardiogram Is Correlated With Severe Coronary Artery Disease and Abnormal Myocardial Perfusion Scintigraphy Results in Renal Transplant Candidates.
- Author
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Çiftci O, Keskin S, Karaçağlar E, Yılmaz KC, Aktaş A, Sezer S, Moray G, Müderrisoğlu İH, and Haberal M
- Subjects
- Action Potentials, Adult, Aged, Aged, 80 and over, Coronary Angiography, Coronary Artery Disease complications, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease physiopathology, Coronary Circulation, Female, Heart Rate, Humans, Kidney Failure, Chronic complications, Kidney Failure, Chronic diagnosis, Male, Medical Records, Middle Aged, Predictive Value of Tests, Retrospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Turkey, Waiting Lists, Young Adult, Coronary Artery Disease diagnosis, Electrocardiography, Kidney Failure, Chronic surgery, Kidney Transplantation, Myocardial Perfusion Imaging methods, Radionuclide Imaging methods
- Abstract
Objectives: Coronary artery disease is a major cause of mortality and morbidity after renal transplant. Fragmented QRS on standard 12-lead electrocardiograms has been proposed as a marker of myocardial scar, mainly due to coronary artery disease. Here, we aimed to investigate fragmented QRS to detect severe coronary artery disease in renal transplant candidates., Materials and Methods: We retrospectively reviewed the medical records of 534 patients with end-stage renal failure who were on the deceased-donor renal transplant wait list at Başkent University Faculty of Medicine due to having no living kidney donor available. We evaluated patients with standard 12-lead electrocardiograms, myocardial perfusion scintigraphy, and coronary angiography. We compared fragmented QRS prevalence versus myocardial perfusion scintigraphy abnormalities and severe coronary artery disease. Correlations among these were analyzed., Results: Of 92 renal transplant candidates (median age of 56.5 y; range, 24-80 y), 87 patients (94.6%) had myocardial perfusion defects and 72 (78.3%) had myocardial wall motion abnormalities on myocardial perfusion scintigraphy. Forty-four patients (47.8%) had severe coronary artery disease on coronary angiography, and 51 patients (55.4%) had fragmented QRS. Fragmented QRS was significantly more common among patients with myocardial scar. Coronary artery disease was significantly more common in patients with fragmented QRS (P = .042) and in those with fragmented QRS combined with myocardial perfusion defects (P < .01). Fragmented QRS was significantly correlated with presence of myocardial scar and any perfusion defects. When combined with myocardial perfusion defects, fragmented QRS was significantly correlated with severe coronary artery disease (P < .05)., Conclusions: Fragmented QRS was significantly correlated with abnormal myocardial perfusion scintigraphy and severe coronary artery disease in renal transplant candidates. This simple parameter can provide valuable information on severe coronary artery disease and help to prevent excess patient morbidity and mortality from this disease after renal transplant.
- Published
- 2018
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