Association between uterine leiomyoma and fragmented QRS waves: a prospective case-control study

Tatlici, Tugce Kacan; Cetin, Nurullah; Korpe, Busra; Kose, Caner; Korkmaz, Vakkas

doi:10.1590/1806-9282.20231359

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 70 (4) • 2024 • https://doi.org/10.1590/1806-9282.20231359 copy

Association between uterine leiomyoma and fragmented QRS waves: a prospective case-control study

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

The aim of this study was to evaluate the relationship between uterine leiomyoma and fragmented QRS, a non-invasive indicator of cardiovascular risk and myocardial ischemia, in women with uterine leiomyoma.

METHODS:

In this prospective case-control study, a total of 47 patients diagnosed with uterine leiomyoma (case group) and 47 healthy individuals without uterine leiomyoma (control group) who had undergone bilateral tubal ligation surgery were included. Various demographic, clinical, and laboratory parameters and the presence of fragmented QRS were recorded.

RESULTS:

The leiomyoma group showed significantly higher body mass index (27.46±2.18 vs. 25.9±2.87 kg/m²2 Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017;124(10):1501-12. https://doi.org/10.1111/1471-0528.14640
https://doi.org/10.1111/1471-0528.14640... , p=0.005) and waist circumference (91.34±9.30 vs. 84.97±9.3 cm, p=0.001) compared with the control group. Uterine volumes were also significantly higher in the leiomyoma group (235.75±323.48 vs. 53.24±12.81 mm³3 Lethaby A, Vollenhoven B. Fibroids (uterine myomatosis, leiomyomas). BMJ Clin Evid. 2015;2015:0814. PMID: 26032466, p<0.001). The presence of fragmented QRS was detected in 18.1% of the patients. Multiple regression analysis identified age, fasting blood glucose value, and the presence of fragmented QRS as independent risk factors for the presence of leiomyoma.

CONCLUSION:

This study provides valuable insights into the relationship between uterine leiomyoma and fragmented QRS. The presence of fragmented QRS was identified as an independent risk factor for the presence of leiomyoma. Further research is needed to better understand the underlying mechanisms connecting uterine leiomyoma and cardiovascular health.

KEYWORDS:
Cardiovascular risk; Fibroids; Electrocardiography; Leiomyoma

	Total patients (n=94)	Leiomyoma group (n=47)	Control group (n=47)	p-value
Age (years)	38.86±4.69	41.29±3.56	36.42±4.43	<0.001
Gravidity	3 (1–7)	3 (1–7)	4 (1–7)	0.234
Parity	3 (0–6)	2 (0–5)	3 (1–6)	0.126
BMI (kg/m²2 Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017;124(10):1501-12. https://doi.org/10.1111/1471-0528.14640 https://doi.org/10.1111/1471-0528.14640... )	26.7±2.65	27.46±2.18	25.9±2.87	0.005
Abdominal circumference (cm)	88.15±9.81	91.34±9.30	84.97±9.35	0.001
Endometrial thickness (mm)	5.81±3.67	5.88±4.46	5.75±2.69	0.867
Uterine volume (mm³3 Lethaby A, Vollenhoven B. Fibroids (uterine myomatosis, leiomyomas). BMJ Clin Evid. 2015;2015:0814. PMID: 26032466)	144.49±245.47	235.75±323.48	53.24±12.81	<0.001
fQRS positivity (n, %)	17 (18.1)	14 (29.8)	3 (6.4)	0.006
WBC (mm³3 Lethaby A, Vollenhoven B. Fibroids (uterine myomatosis, leiomyomas). BMJ Clin Evid. 2015;2015:0814. PMID: 26032466)	8148.01±2812.26	8551.48±3149.11	7744.53±2395.83	0.165
Hemoglobin (g/dL)	12.08±1.61	11.45±1.47	12.7±1.51	<0.001
Hematocrit (%)	36.8±4.47	35.15±4.25	38.45±4.1	<0.001
Thrombocyte count (1/μL)	279.550±73.515	282.82±81.25	279.27±65.58	0.668
Glucose (mg/dL)	96.93±17.39	104.34±20.19	89.53±9.60	<0.001
HgA1c (%)	5.3±0.44	5.29±0.47	5.30±0.42	0.869
Insuline (mIU/mL)	12.60±1.55	13.60±1.94	11.61±10.62	0.538
ALT (U/L)	16.05±7.41	15.55±8.52	16.5±6.16	0.516
AST (U/L)	18.67±3.76	18.19±3.69	19.14±3.82	0.220
BUN (mg/dL)	9.71±3.014	8.66±2.68	10.76±2.98	0.001
Creatinine (mg/dL)	0.60±0.090	0.59±0.10	0.60±0.069	0.359
HDL (mg/dL)	51.17±13.03	48.82±13.36	53.51±12.39	0.082
LDL (mg/dL)	107.79±33.26	104.61±32.37	110.97±34.18	0.357
TG (mg/dL)	110.75±56.37	116.34±50.66	105.17±61.61	0.340
Cholesterol (mg/dL)	179.50±40.45	176.32±36.76	182.67±44.01	0.453
VLDL (mg/dL)	21.32±11.13	21.61±9.90	21.04±12.35	0.804
FSH (mlU/mL)	12.22±4.38	17.63±6.15	6.82±6.08	0.237
E2 (pg/mL)	74.072±16.65	90.51±45.77	77.63±23.42	0.141
LH (mlU/mL)	8.98±0.908	8.47±1.003	9.48±8.09	0.594
Heart rate (beat/min)	77.106±9.98	78.74±10.26	75.46±9.52	0.112
QT interval (ms)	373.17±24.14	373.12±28.78	373.21±18.72	0.986
QTc interval (ms)	423.117±27.31	428.06±31.67	418.17±21.34	0.080
HOMA-IR	3.24±3.34	3.85±6.9	2.63±2.61	0.257

	fQRS (-)	fQRS (+)	p-value
	(n=33)	(n=14)	p-value
Age (years)	41.03±3.77	41.92±3.04	0.436
Gravidity	2.6±1.29	3.5±1.45	0.043
Parity	2.06±0.78	2.85±1.16	0.009
BMI (kg/m²2 Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017;124(10):1501-12. https://doi.org/10.1111/1471-0528.14640 https://doi.org/10.1111/1471-0528.14640... )	27.2±2.33	27.8±1.79	0.427
Abdominal circumference (cm)	91.8±9.11	90.0±9.94	0.548
Endometrial thickness (mm)	5.77±4.51	6.14±4.52	0.798
Uterine volume (mm³3 Lethaby A, Vollenhoven B. Fibroids (uterine myomatosis, leiomyomas). BMJ Clin Evid. 2015;2015:0814. PMID: 26032466)	259.7±79.91	179.3±100.54	0.442
Leiomyoma volume (mm³3 Lethaby A, Vollenhoven B. Fibroids (uterine myomatosis, leiomyomas). BMJ Clin Evid. 2015;2015:0814. PMID: 26032466)	303.55±21.50	256.88±18.39	0.482

	Odds ratio (95%CI)	p-value
Age (years)	0.688 (0.569–0.833)	<0.001
BMI (kg/m²2 Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017;124(10):1501-12. https://doi.org/10.1111/1471-0528.14640 https://doi.org/10.1111/1471-0528.14640... )	0.813 (0.610–1.082)	0.156
Waist circumference (cm)	0.942 (0.862–1.029)	0.187
Glucose (mg/dL)	0.893 (0.829–0.963)	0.003
fQRS	11.350 (1.235–104.338)	0.032

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[1] *Corresponding author: busraejderoglu@yahoo.com