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Fragmented QRS: a novel marker of cardiovascular diseases in patients with erectile dysfunction

Background The most common cause of erectile dysfunction (ED) is vascular insufficiency. Fragmented QRS (fQRS) is an ECG marker of myocardial ischemia in patients with coronary artery disease. Objectives To evaluate if the fQRS by ECG can be detected earlier and if it is possible to track simpler markers of cardiovascular involvement in patients with arteriogenic ED than pharmaco-penile duplex ultrasonography. Patients and methods A total of 100 patients with ED were included. They were classified according to International Index of Erectile Function-5 and subjected to detailed history taking, thorough clinical examination, and imaging studies, including pharmaco-penile duplex ultrasonography and ECG, to detect fQRS. Results The presence of fQRS was significantly different among the studied groups (P = 0.005), as 66.7% of patients with severe ED and 60% of patients with moderate ED had fQRS, whereas 28.6% of patients with mild–moderate ED and 24% of patients with mild ED had fQRS. fQRS was more specific (83%) than sensitive (56%), with an accuracy of 72% in arteriogenic ED prediction. Conclusion fQRS is an efficient specific and simple marker of arteriogenic ED. Absent fQRS can exclude the arteriogenic ED, and the patient could be considered normal or venogenic.