The relation of fragmented QRS with tissue Doppler derived parameters in patients with b-thalassaemia major

Eyup Buyukkaya, Mehmet Fatih Karakas, Mustafa Kurt, Perihan Bilen, Fatih Yalcin, Murat Celik, Rami Helvaci, Hasan Kaya, Filiz Ertekin, Erdogan Sökmen, Nihat Sen, Adnan Burak Akcay

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8 Scopus citations


Purpose: The most important complication encountered in patients with b-thalassaemia major is degenerative fibrosis developing as a result of iron accumulation in myocardial tissue. Dysfunction pursues this accumulation. Recently, presence of fragmented QRS (fQRS) in ECG has been regarded as a predictor of myocardial fibrosis. We aimed in our study to investigate the frequency with which fQRS develops in patients with b-thalassaemia major and to disclose the correlation between fQRS frequency and Doppler-derived indices. Methods: The patients with b-thalassaemia major (n=66; mean age: 23±6 years) and healthy controls (n=30; mean age: 23±4 years) were included. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings. 2D, M-mode, conventional Doppler, tissue Doppler echocardiography parameters were assessed. Mean serum ferritin levels over past 5 years were also calculated. Results: When compared to those in control group, fQRS was more frequent in bthalassaemia major group, indicating statistical significance (p = 0.001). While E/Em and ferritin level exhibited statistically significant increase in thalassaemia patients with fQRS (p <0.05), the mean Em and Sm values were found to be significantly low (p <0.05). Conclusions: fQRS was frequently observed in the patients with b-thalassaemia major, which was of statistical significance. Tissue Doppler-derived diastolic and systolic indices in thalassaemia cases with fQRS showed statistically significant impairment compared to those without fQRS. In conclusion, fQRS may represent a novel noninvasive marker for cardiac involvement in patients with b-thalassaemia major.

Original languageEnglish (US)
JournalClinical and Investigative Medicine
Issue number5
StatePublished - 2012
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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