{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T20:31:48Z","timestamp":1774902708161,"version":"3.50.1"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,11,19]],"date-time":"2020-11-19T00:00:00Z","timestamp":1605744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Takeda Science Foundation and the Japan Cardiovascular Research Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims\u2003<\/jats:title>\n                  <jats:p>To evaluate the prognostic impact of fragmented QRS (fQRS) on idiopathic dilated cardiomyopathy (DCM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results\u2003<\/jats:title>\n                  <jats:p>We conducted a prospective observational study of 290 consecutive patients with DCM (left ventricular ejection fraction \u2264 40%) and narrow QRS who underwent cardiac magnetic resonance. We defined fQRS as the presence of various RSR\u2032 patterns in \u22652 contiguous leads representing the anterior (V1\u2013V5), inferior (II, III, and aVF), or lateral (I, aVL, and V6) myocardial segments. Multiple fQRS was defined as the presence of fQRS in \u22652 myocardial segments. Patients were divided into three groups: no fQRS, single fQRS, or multiple fQRS. The primary endpoint was a composite of hard cardiac events consisting of heart failure death, sudden cardiac death (SCD), or aborted SCD. The secondary endpoints were all-cause death and arrhythmic event. During a median follow-up of 3.8\u2009years (interquartile range, 1.8\u20136.2), 31 (11%) patients experienced hard cardiac events. Kaplan\u2013Meier analysis showed that the rates of hard cardiac events and all-cause death were similar in the single-fQRS and no-fQRS groups and higher in the multiple-fQRS group (P\u2009=\u20090.004 and P\u2009=\u20090.017, respectively). Multivariable Cox regression identified that multiple fQRS is a significant predictor of hard cardiac events (hazard ratio, 2.23; 95% confidence interval, 1.07\u20134.62; P\u2009=\u20090.032). The multiple-fQRS group had the highest prevalence of a diffuse late gadolinium enhancement pattern (no fQRS, 21%; single fQRS, 22%; multiple fQRS, 39%; P\u2009&amp;lt;\u20090.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion\u2003<\/jats:title>\n                  <jats:p>Multiple fQRS, but not single fQRS, is associated with future hard cardiac events in patients with DCM.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa193","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T11:25:55Z","timestamp":1594380355000},"page":"287-297","source":"Crossref","is-referenced-by-count":14,"title":["Prognostic impact of multiple fragmented QRS on cardiac events in idiopathic dilated cardiomyopathy"],"prefix":"10.1093","volume":"23","author":[{"given":"Kyohei","family":"Marume","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan"},{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-4932","authenticated-orcid":false,"given":"Teruo","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsukasa","family":"Kamakura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emi","family":"Tateishi","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiaki","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuriko","family":"Nakaoku","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunihiro","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoaki","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Radiology, Osaka Neurological Institute, Toyonaka, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Tsujita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chisato","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka 564-8565, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kengo","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular 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