The relationship of QRS morphology with cardiac structure and function in patients with heart failure View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-11

AUTHORS

Pierpaolo Pellicori, Anil C. Joseph, Jufen Zhang, Elena Lukaschuk, Nasser Sherwi, Christos V. Bourantas, Huan Loh, Andrew L. Clark, John GF Cleland

ABSTRACT

INTRODUCTION: The relationship of QRS morphology with cardiac structure and function in patients with heart failure is uncertain. METHODS: Patients with a clinical diagnosis of heart failure and objective evidence of cardiac dysfunction [either a left ventricular ejection fraction (LVEF) <50 % or an amino-terminal pro-brain natriuretic peptide (NT-proBNP) ≥400 pg/ml] who had been investigated by cardiac magnetic resonance imaging (CMRI) were identified. QRS duration ≥120 ms was grouped morphologically as left (LBBB), right bundle branch block (RBBB) or indeterminate. RESULTS: Of 877 patients, 320 (36 %) had QRS ≥ 120 ms. Compared to patients with LBBB, those with RBBB had a lower median [inter-quartile range (IQR)] right ventricular (RV) ejection fraction [RBBB: 46 (37-57); LBBB: 52 (42-61) %; p = 0.014], greater median (IQR) RV mass [RBBB: 53 (42-73); LBBB: 45 (36-56) g; p < 0.001], higher median (IQR) plasma NT-proBNP [RBBB: 2013 (659-3573); LBBB: 1159 (589-2207) pg/ml, p = 0.026], more signs of peripheral congestion and higher prevalence of atrial fibrillation but had similar LVEF. During a median follow-up of 1302 days (IQR: 742-2237), 311 patients died. Compared with patients who had QRS < 120 ms, those with RBBB [HR 1.98, 95 % CI (1.37-2.86); p < 0.001] had a higher mortality. Age and NT-proBNP were the strongest independent predictors of mortality; neither QRS nor CMRI variables improved prediction. CONCLUSIONS: In patients with heart failure and QRS ≥ 120 ms, RBBB is associated with more severe RV dysfunction and congestion and a worse prognosis. However, neither QRS morphology nor CMRI data provide independent prognostic information in a multivariable analysis including NT-proBNP. More... »

PAGES

935-945

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00392-015-0861-0

DOI

http://dx.doi.org/10.1007/s00392-015-0861-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1045416877

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25903113


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RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s00392-015-0861-0'


 

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