| Title: | Fragmented QRS on 12-lead electrocardiogram predicts long-term prognosis in patients with cardiac sarcoidosis |
| Authors: | Hagiwara, Hikaru Browse this author |
| Watanabe, Masaya Browse this author →KAKEN DB |
| Kadosaka, Takahide Browse this author |
| Koizumi, Takuya Browse this author |
| Kobayashi, Yuta Browse this author |
| Koya, Taro Browse this author |
| Nakao, Motoki Browse this author |
| Tsuneta, Satonori Browse this author |
| Kato, Yoshiya Browse this author |
| Komoriyama, Hirokazu Browse this author |
| Kamada, Rui Browse this author |
| Nagai, Toshiyuki Browse this author →KAKEN DB |
| Kudo, Kohsuke Browse this author →KAKEN DB |
| Anzai, Toshihisa Browse this author →KAKEN DB |
| Keywords: | Cardiac sarcoidosis |
| Electrocardiography |
| Fragmented QRS |
| Ventricular arrhythmias |
| Issue Date: | 1-Jun-2023 |
| Publisher: | Springer |
| Journal Title: | Heart and vessels |
| Volume: | 38 |
| Issue: | 6 |
| Start Page: | 803 |
| End Page: | 816 |
| Publisher DOI: | 10.1007/s00380-022-02229-2 |
| Abstract: | Fragmented QRS (fQRS) on a 12-lead electrocardiogram is a known marker of fatal arrhythmias or cardiac adverse events in ischemic and non-ischemic cardiomyopathy patients. Nonetheless, the association between fQRS and clinical outcomes in patients with cardiac sarcoidosis (CS) remains unclear. Herein, we investigated whether fQRS is associated with longterm clinical outcomes in CS patients. A total of 78 patients who received immunosuppressive therapy (IST) for clinically diagnosed CS were retrospectively examined. Patients were classified into two groups according to the presence (n = 19) or absence (n = 59) of fQRS on electrocardiogram before IST. The primary outcome was the composite event of all-cause death, ventricular tachyarrhythmias (VTs), and hospitalization for heart failure. Results of late gadolinium enhancement on cardiac magnetic resonance imaging were also analyzed. During a median follow-up period of 3.7 years (interquartile range: 1.6-6.2 years), the primary outcome occurred more frequently in patients with fQRS than in those without (47% vs. 13%, log-rank p = 0.002). Multivariable Cox regression analyses showed that fQRS was an independent determinant of the primary outcome. The incidence of VTs, within 12 months of IST initiation, was comparable between the two groups; however, late-onset VTs, defined as those occurring >= 12 months after IST initiation, occurred more frequently in the fQRS group (21% vs. 2%, log-rank p = 0.002). The scar zone and scar border zone were greater in patients with fQRS than in those without it. In conclusion, our analysis suggests that fQRS is an independent predictor of adverse events, particularly late-onset VTs, in patients with CS. |
| Rights: | This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/doi.org/10.1007/s00380-022-02229-2 |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/92732 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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