Background

Hypertensive crisis (HC) is a life-threatening condition in patients with hypertension (HT). However, there is no electrocardiography (ECG) marker that can predict which hypertensive patient may develop HC. The fragmented QRS (fQRS) complex is an important prognostic marker in ECG that might be predict cardiovascular events and mortality. Our study aimed to investigate whether fQRS can predict the development of HC in patients with HT, within 4 years of follow-up.

Methods

Newly diagnosed patients with essential HT were recruited for the study from an outpatient clinic. The patients were divided into two groups according to the presence of HC: HC (+) and HC (−). During follow-up, the relationship between fQRS and HC was evaluated.

Results

The study group included 504 patients with newly diagnosed HT. During the follow-up period, HC occurred in 98 of the patients. In 57 (11.30%) patients, fQRS was observed on ECG; fQRS was detected in the ECG of 19 (19.38%) of the HC (+) patients (p = 0.008). The results of multivariate logistic regression analysis showed that fQRS (p < 0.001) was as independent predictor for HC development. Kaplan–Meier analysis further demonstrated that the presence of fQRS affects the development of hypertensive urgency in hypertensive patients (log-rank p < 0.001).

Conclusion

In patients with newly diagnosed HT, the presence of fQRS was found to be an independent predictor of HC.

中文翻译：

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碎片 QRS 波作为新诊断原发性高血压患者高血压危象的预测因子：4 年随访数据

背景

高血压危象（HC）是高血压（HT）患者的一种危及生命的疾病。然而，没有心电图 (ECG) 标记物可以预测哪些高血压患者可能会发展为 HC。碎片 QRS (fQRS) 复合体是心电图的重要预后标志物，可预测心血管事件和死亡率。我们的研究旨在调查 fQRS 是否可以预测 HT 患者在随访 4 年内发生 HC 的情况。

方法

该研究从门诊招募了新诊断的原发性 HT 患者。根据HC的存在将患者分为两组：HC（+）和HC（-）。随访期间，评估了 fQRS 与 HC 之间的关系。

结果

该研究组包括 504 名新诊断为 HT 的患者。在随访期间，98 名患者发生了 HC。57 例（11.30%）患者心电图观察到 fQRS；19 名 (19.38%) HC (+) 患者的 ECG 中检测到 fQRS ( p  = 0.008)。多变量逻辑回归分析结果表明，fQR​​S ( p  < 0.001) 是 HC 发展的独立预测因子。Kaplan-Meier 分析进一步证明，fQR​​S 的存在会影响高血压患者高血压急迫性的发展（对数秩p  < 0.001）。

结论

在新诊断的 HT 患者中，fQRS 的存在被发现是 HC 的独立预测因子。