The Relationship between the Retinal Nerve Fiber Layer Thickness and the Presence of Fragmented QRS Complexes in Patients with Hypertension

J Clin Exp Invest 2019;10(1):em00719.


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Background: Fragmented QRS (fQRS) detected on electrocardiography (ECG) has been demonstrated to be a marker of myocardial fibrosis in hypertensive patients. Retinal microvascular abnormalities reflect cumulative microcirculatory damage resulting from hypertension and atherosclerosis. In this study, we aimed to evaluate the retinal nerve fiber layer (RNFL) thickness in hypertensive patients with and without fQRS complexes detected on ECG.
Methods: Consecutive patients who were diagnosed with hypertension were included in the study. ECG and transthoracic echocardiography were performed to all patients. fQRS was defined as additional R’ wave or notching/splitting of S wave in two contiguous ECG leads. The RNFL thickness was measured by a spectral-domain optical coherence tomography device along a circle around the center of the optic disc.
Results: This observational case-control study enrolled 62 (42 female, mean age: 54.3±9.9 years) hypertensive patients with fQRS and 42 (24 female, mean age: 53.1±11.8 years) hypertensive control patients without fQRS between April 2017 and October 2017. There was no significant difference between groups regarding demagraphic, laboratory and echocardiographic parameters. In all retinal quadrants, the mean RNFL thickness did not differ significantly between patients with fQRS(+) and fQRS(-) group.
Conclusion: The presence of fQRS in the ECG had no significant effect on the RNFL thickness in hypertensive patients. Detection of fQRS may not be used as a useful non-invasive technique in the evaluation of atherosclerosis in hypertensive patients.


echocardiography, electrocardiography, fragmented QRS, retinal nerve fiber layer, optical coherence tomography


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Doğan T, Yetim M, Kalçık M, Kocamış Sİ, Dönmez O, Bekar L. The Relationship between the Retinal Nerve Fiber Layer Thickness and the Presence of Fragmented QRS Complexes in Patients with Hypertension. J Clin Exp Invest. 2019;10(1):em00719.