Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 20 4 2025 12 06 259 265 Aida Mohamadi Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Tamartash Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Sepehr Nayebirad Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Farhad Gharibdoost Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Javady Nejad Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran. Maedeh Majidi Shad Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Motahare Hatami Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Hoda Kavosi Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2025 07 21 2025 09 23 Background: Systemic sclerosis (SSc) is an autoimmune connective tissue disorder that leads to fibrosis of the skin and internal organs. Fragmented QRS (fQRS) is an important electrocardiographic (ECG) finding related to myocardial fibrosis. This study aimed to evaluate the effect of fQRS on ejection fraction (EF) and other echocardiographic parameters in individuals diagnosed with SSc. Methods: This was a retrospective cohort study consisting of 52 patients with fQRS as the case group and 60 patients without fQRS as the control group. The characteristics and echocardiographic parameters of the patients from a minimum of a 3-year interval were recorded. All data were compared between the two groups using SPSS software, version 20.0 (IBM Corp). Results: There were no significant differences in demographics, paraclinical results, and echocardiographic parameters, including average EF, pulmonary hypertension, and tricuspid regurgitation velocity, between cases and controls at the beginning and end of the follow-up. Conclusion: Based on our results, fQRS had no significant effect on EF and other echocardiographic parameters over at least a 3-year interval in SSc patients. However, additional research with longer follow-up periods and larger sample sizes is needed to characterize the association fully. https://jthc.tums.ac.ir/index.php/jthc/article/view/2311 https://jthc.tums.ac.ir/index.php/jthc/article/download/2311/1238