Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2022; 14(9): 483-495
Published online Sep 26, 2022. doi: 10.4330/wjc.v14.i9.483
Association of electrocardiographic markers with myocardial fibrosis as assessed by cardiac magnetic resonance in different clinical settings
George Bazoukis, Sebastian Garcia-Zamora, Göksel Çinier, Sharen Lee, Enes Elvin Gul, Jesús Álvarez-García, Gabi Miana, Mert İlker Hayıroğlu, Gary Tse, Tong Liu, Adrian Baranchuk
George Bazoukis, Department of Cardiology, Larnaca General Hospital, Larnaca 6036, Cyprus
George Bazoukis, Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia 2414, Cyprus
Sebastian Garcia-Zamora, Department of Cardiology, Delta Clinic, Santa Fe 341, Argentina
Göksel Çinier, Mert İlker Hayıroğlu, Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Center, Istanbul 34668, Turkey
Sharen Lee, Cardiovascular Analytics Group, Laboratory of Cardiovascular Physiology, Hong Kong 999077, China
Enes Elvin Gul, Division of Cardiac Electrophysiology, Madinah Cardiac Centre, Madinah 42351, Saudi Arabia
Jesús Álvarez-García, Department of Cardiology, Ramon y Cajal University Hospital, Madrid 28034, Spain
Gabi Miana, Telehealth Center of Hospital das Clínicas, Hong Kong 999077, China
Gary Tse, Kent and Medway Medical School, Canterbury, Canterbury CT2 7FS, United Kingdom
Gary Tse, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin, Tianjin Medical University, Tianjin 300211, China
Tong Liu, Department of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
Adrian Baranchuk, Department of Cardiology, Queen's University, Ontario K7L 3N6, Canada
Author contributions: Bazoukis G had the inception of the idea and wrote the first draft; Bazoukis G and Garcia-Zamora S performed the systematic search; Bazoukis G, Garcia-Zamora S, Cinier G, Lee S, Gul EE, García JA, Miana G, Hayıroğlu MI, Tse G, Liu T, and Baranchuk A performed major revisions and approved the final manuscript; Baranchuk A supervised the study.
Conflict-of-interest statement: All authors declare no conflicts of interest.
PRISMA 2009 Checklist statement: All authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: George Bazoukis, MD, PhD, Doctor, Department of Cardiology, Larnaca General Hospital, Inomenon Polition Amerikis, Larnaca 6036, Cyprus. gbazoykis@yahoo.gr
Received: April 9, 2022
Peer-review started: April 9, 2022
First decision: May 31, 2022
Revised: May 31, 2022
Accepted: August 17, 2022
Article in press: August 17, 2022
Published online: September 26, 2022
ARTICLE HIGHLIGHTS
Research background

Electrocardiogram (ECG) is a well-established, easily obtained, low-cost diagnostic tool that is the cornerstone of cardiological evaluation. ECG markers have been associated with the presence of myocardial fibrosis, as depicted from cardiac magnetic resonance (CMR) evaluation.

Research motivation

ECG can be a valuable tool for the risk stratification of sudden cardiac death in different clinical settings.

Research objectives

To elucidate the association of ECG markers with CMR-late gadolinium enhancement in different clinical settings.

Research methods

Methodology of Systematic reviews in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA Statement).

Research results

Our results summarize the existing evidence about the association of ECG markers with fibrosis as identified by CMR. Existing data show that fragmented QRS, Q waves and repolarization abnormalities are some of the ECG indices that are associated with myocardial fibrosis.

Research conclusions

Myocardial fibrosis, a marker of prognosis in a wide spectrum of clinical settings, can be easily identified by ECG indices.

Research perspectives

Future research should be focused on the identification of ECG markers that are reliably associated with myocardial fibrosis in different clinical settings. Furthermore, the association of ECG markers with all-cause mortality and arrhythmic events is of great importance.