Investigation of FGF-23 levels in hypertensive patients with QRS fragmentation on electrocardiography and left ventricular hypertrophy on echocardiography

Aim: The aim of this study was to compare fibroblast growth factor 23 (FGF23) levels and other clinical parameters between hypertensive patients with left ventricular hyperthyrophy (SVH) on echocardiography and patients with and without fragmented QRS (fQRS) on electrocardiography (ECG). Materials and Methods: A total of 104 hypertensive patients with SVH detected by echocardiography performed between September 2023 and November 2023 at Hitit University Faculty of Medicine, Department of Internal Medicine and Cardiology were included in this case-control study. The patients were divided into two groups: 55 (52.9%) patients with fQRS on electrocardiography and 49 (47.1%) patients without fQRS. Results: 66.3% of the patients were female and the mean age was 58.39 ± 11.73 years. The mean FGF23 was 758.46 ± 205.41 pg/mL. Compared with patients without fQRS, FGF23 levels were significantly higher in patients with fQRS (672.46 ± 223.1 vs. 835.07 ± 153.45, p<0.001) and E/A ratio was significantly lower (0.96 ± 0.08 vs. 0.91 ± 0.12, p = 0.012). FGF23 level ideally detected the presence of fQRS on ECG at the cut-off point >855.83 pg/mL with 60.0% sensitivity and 77.6% specificity (AUC: 0.731 [95% CI: 0.635 - 0.827], p<0.001), and E/A ratio <0.95 with a sensitivity of 41.8% and specificity of 80.9% (EAKA: 0.618 [95% CI: 0.510 - 0.727]). There was no statistically significant difference between the groups of patients with and without fQRS on ECG in terms of other parameters (p>0.05). Conclusion: In this study, we found that FGF23 levels were higher in hypertensive SVH patients with fQRS on ECG. In line with this indirect result, it was thought that increased FGF23 may be a potential indicator of myocardial fibrosis. Keywords: Fragmented QRS, Left Ventricular Hypertrophy, Hypertension, Fibroblast Growth Factor-23