The following is a summary of “Fragmented QRS complex could predict all-cause mortality in patients with connective tissue disease-associated pulmonary arterial hypertension,” published in the February 2024 issue of Rheumatology by Dai et al.
Researchers conducted a retrospective study to assess whether fragmented QRS complex (fQRS) impacts prognosis and reveals underlying mechanisms in connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH).
They involved 141 patients diagnosed with CTD-PAH via right heart catheterization (discovery cohort: 114 cases; validation cohort: 27 cases), fQRS and ST-T changes were identified on standard 12-lead ECG. Patients underwent follow-up every 3 months for status updates, with all-cause death as the primary endpoint. Clinical data and ECG features between survival and deceased groups were compared, and survival analysis was performed using Kaplan-Meier curves.
The results showed disparities in age, sex, 6-min walk distance, NT-proBNP, WHO classification, fQRS presence, and ST-T change in inferior leads between the survival and death groups. Inferior fQRS and ST-T change correlated significantly with right ventricular (RV) dilatation and reduced RV ejection fraction (RVEF). Kaplan-Meier curve analysis indicated higher all-cause mortality in CTD-PAH patients with fQRS (P=0.003) and inferior ST-T change (P=0.012). Low- and intermediate-risk CTD-PAH patients with inferior ST-T change exhibited elevated all-cause mortality (P=0.005). The fQRS and inferior ST-T change were validated externally.
Investigators concluded that inferior fQRS and ST-T changes emerged as potential predictors of poor outcomes in patients with CTD-PAH.
