Prognostic value of fragmented QRS in acute pulmonary embolism: a cross-sectional-analytic study of the Iranian population

Mahsa Asadi Anar; Akram Ansari; Gisou Erabi; Mohammad Rahmanian; Mahdiyeh Movahedi; Fatemeh Chichagi; Niloofar Deravi; Farid Taghavi; Babak Kazemi; Elnaz Javanshir; Erfan Amouei; Samad Ghaffari

Prognostic value of fragmented QRS in acute pulmonary embolism: a cross-sectional-analytic study of the Iranian population

Am J Cardiovasc Dis. 2023 Feb 15;13(1):21-28. eCollection 2023.

Authors

Affiliations

¹ Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences Tehran, Iran.
² Medical Student, Shantou University Medical College Shantou, Guangdong, China.
³ Student Research Committee, Urmia University of Medical Sciences Urmia, Iran.
⁴ Shahid Beheshti University of Medical Sciences Tehran, Iran.
⁵ Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences Tehran, Iran.
⁶ Cardiovascular Research Center, Tabriz University of Medical Sciences Tabriz, Iran.
⁷ Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Science Tehran, Iran.

PMID: 36938519
PMCID: PMC10017924

Abstract

Background: Acute Pulmonary embolism (APE) is considered one of the deadliest cardiovascular diseases. Electrocardiographic (ECG) abnormalities in pulmonary embolism (PE) are increasingly reported. A growing number of studies have recommended that ECG plays a crucial role in the prognostic assessment of PE patients. However, there is scarce data on the prognostic importance of fragmented QRS (fQRS) on outcomes in patients with APE. This study aims to investigate the prognostic value of fQRS in APE patients.

Materials and methods: This is a cross-sectional-analytic study. This study included 280 patients diagnosed with APE admitted to Shahid Madani hospital, Tabriz, Iran. Computed tomography pulmonary angiography (CTPA) was used to diagnose APE. A checklist was prepared for all patients, demographic, clinical characteristics, and Major Adverse Cardiopulmonary events (MACPE), including in-hospital mortality, need for thrombolysis, mechanical ventilation, and surgical embolectomy, were recorded. Patients were divided into two groups: patients who manifested fQRS on their ECG and patients who did not; Then, demographic, clinical characteristics, and MACPE were compared in the two groups, as mentioned earlier. Furthermore, all statistical analyses were carried out using SPSS software.

Results: 48 patients (17.14%) had fQRS(+) on their ECG, and 232 patients (82.86%) did not have it on their ECG. In data analysis, 22 patients (8.7%) had in-hospital mortality, 35 patients (13.9%) needed thrombolysis, nine patients (3.9%) required mechanical ventilation, and 13 patients (5.1%) needed surgical embolectomy. fQRS was not significantly associated with in-hospital mortality (P = 0.225), need for thrombolysis (P = 0.684), mechanical ventilation (P = 1.000), and surgical embolectomy (P = 1.000). Demographic and clinical characteristics were also similar in both groups.

Conclusions: This study does not support the idea that fQRS on ECG is a valuable predictor of in-hospital mortality, the need for thrombolysis, mechanical ventilation, and surgical embolectomy.

Keywords: Fragmented QRS (fQRS); acute pulmonary embolism (APE); prognostic value.