Background

Fragmented QRS (fQRS) on 12-lead electrocardiogram (ECG) is associated with scarred myocardium and adverse outcome. However, the data on gender differences in terms of its prevalence and prognostic value is sparse. The aim of this study was to evaluate whether gender differences in fQRS exist among subjects drawn from populations with different risk profiles.

Methods

We analyzed fQRS from 12-lead ECG in 953 autopsy-confirmed victims of sudden cardiac death (SCD) (78% men; 67.0 ± 11.4 yrs), 1900 coronary artery disease (CAD) patients with angiographically confirmed stenosis of ≥50% (70% men; 66.6 ± 9.0 yrs, 43% with previous myocardial infarction [MI]), and in 10,904 adults drawn from the Finnish adult general population (52% men; 44.0 ± 8.5 yrs).

Results

Prevalence of fQRS was associated with older age, male sex and the history and severity of prior cardiac disease of subjects. Among the general population fQRS was more commonly found among men in comparison to women (20.5% vs. 14.8%, p < 0.001). The prevalence of fQRS rose gradually along with the severity of prior cardiac disease in both genders, yet remained significantly higher in the male population: subjects with suspected or known cardiac disease (25.4% vs. 15.8% p < 0.001), CAD patients without prior MI (39.9% vs. 26.4%, p < 0.001), CAD patients with prior MI (42.9% vs. 31.2%, p < 0.001), and victims of SCD (56.4% vs. 44.4%, p < 0.001).

Conclusions

The prevalence of QRS fragmentation varies in different populations. The fragmentation is clearly related to the underlying cardiac disease in both genders, however women seem to have significantly lower prevalence of fQRS in each patient population in comparison to men.

中文翻译：

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支离破碎的QRS复合体的患病率和预后价值存在性别差异。

背景

12导联心电图（ECG）上的QRS碎片（fQRS）与心肌疤痕和不良预后相关。但是，关于性别差异的流行率和预后价值方面的数据很少。这项研究的目的是评估在具有不同风险特征的人群中，受试者之间是否存在fQRS的性别差异。

方法

我们分析了953例经尸检确认的猝死（SCD）的受害者（78％的男性; 67.0±11.4 yrs），1900例经血管造影证实狭窄≥50％的冠状动脉疾病（CAD）患者的12导联心电图的fQRS男性百分比：66.6±9.0岁，以前有心肌梗塞[MI]的比例为43％），以及来自芬兰成年人群的10,904名成年人（52％男性； 44.0±8.5岁）。

结果

fQRS的患病率与年龄，男性以及受试者先前的心脏病史和严重程度有关。在普通人群中，与女性相比，男性更常见fQRS（20.5％vs. 14.8％，p <0.001）。男女中，fQRS的患病率随着既往心脏病的严重程度而逐渐升高，但在男性人群中仍显着较高：患有可疑或已知心脏病的受试者（25.4％比15.8％，p <0.001），无先前病史的CAD患者MI（39.9％vs. 26.4％，p <0.001），先前有MI的CAD患者（42.9％vs. 31.2％，p <0.001）和SCD的患者（56.4％vs. 44.4％，p <0.001）。

结论

QRS碎片的患病率在不同人群中有所不同。支离破碎显然与男女的潜在心脏病有关，但是与男性相比，女性似乎在每个患者人群中的fQRS患病率明显较低。