AIMS: To investigate the hypothesis that changes in the ECG over time may be an important and readily available marker of prognostic value in patients with heart failure. METHODS: 112 elderly patients (81 men) with stable heart failure, a mean (SD) age of 73.3 (4.4) years, left ventricular ejection fraction 38 (17)%, and peak oxygen consumption 15.1 (4.7) ml/kg/min had ECG measurements on two occasions a minimum of 12 (5) months apart. RESULTS: During the subsequent follow up period (mean 27 (17) months) 45 patients died. QRS duration (p = 0.001) and heart rate (p = 0.03) at baseline were found by Cox proportional hazard method analysis to predict adverse outcomes in these patients. Of the changes in ECG parameters between the first and second visit, broadening of QRS duration (p = 0.001) predicted mortality. On Kaplan-Meier survival analysis, patients with < 5% change in QRS duration had fewer end points than patients with 5-20% change. A > 20% increase in QRS duration was associated with the worst prognosis. Progressive prolongation of QRS duration correlated closely with deterioration of LV systolic and diastolic function. CONCLUSION: A single measurement of QRS duration has significant prognostic value in elderly patients with heart failure and the increase in QRS duration over time is an even better predictor of adverse out comes.
AIMS: To investigate the hypothesis that changes in the ECG over time may be an important and readily available marker of prognostic value in patients with heart failure. METHODS: 112 elderly patients (81 men) with stable heart failure, a mean (SD) age of 73.3 (4.4) years, left ventricular ejection fraction 38 (17)%, and peak oxygen consumption 15.1 (4.7) ml/kg/min had ECG measurements on two occasions a minimum of 12 (5) months apart. RESULTS: During the subsequent follow up period (mean 27 (17) months) 45 patients died. QRS duration (p = 0.001) and heart rate (p = 0.03) at baseline were found by Cox proportional hazard method analysis to predict adverse outcomes in these patients. Of the changes in ECG parameters between the first and second visit, broadening of QRS duration (p = 0.001) predicted mortality. On Kaplan-Meier survival analysis, patients with < 5% change in QRS duration had fewer end points than patients with 5-20% change. A > 20% increase in QRS duration was associated with the worst prognosis. Progressive prolongation of QRS duration correlated closely with deterioration of LV systolic and diastolic function. CONCLUSION: A single measurement of QRS duration has significant prognostic value in elderly patients with heart failure and the increase in QRS duration over time is an even better predictor of adverse out comes.
Authors: N B Schiller; P M Shah; M Crawford; A DeMaria; R Devereux; H Feigenbaum; H Gutgesell; N Reichek; D Sahn; I Schnittger Journal: J Am Soc Echocardiogr Date: 1989 Sep-Oct Impact factor: 5.251
Authors: J R Wilson; J S Schwartz; M S Sutton; N Ferraro; L N Horowitz; N Reichek; M E Josephson Journal: J Am Coll Cardiol Date: 1983-09 Impact factor: 24.094
Authors: J L Willems; E O Robles de Medina; R Bernard; P Coumel; C Fisch; D Krikler; N A Mazur; F L Meijler; L Mogensen; P Moret Journal: J Am Coll Cardiol Date: 1985-06 Impact factor: 24.094
Authors: Preeti J Thyparampil; Yangseon Park; M E Martinez-Perez; Thomas C Lee; David J Weissgold; Audina M Berrocal; R V Paul Chan; John T Flynn; Michael F Chiang Journal: Am J Ophthalmol Date: 2010-10 Impact factor: 5.258
Authors: Susan Cheng; Martin G Larson; Michelle J Keyes; Elizabeth L McCabe; Christopher Newton-Cheh; Daniel Levy; Emelia J Benjamin; Ramachandran S Vasan; Thomas J Wang Journal: Am J Cardiol Date: 2010-07-23 Impact factor: 2.778
Authors: Nicolas Lellouche; Carlos De Diego; Noel G Boyle; Isaac Wiener; Gina Akopyan; John S Child; Kalyanam Shivkumar Journal: Europace Date: 2011-04-12 Impact factor: 5.214
Authors: N Bouqata; J Kheyi; F Miftah; H Sabor; A Bouziane; H Bouzelmat; A Chaib; A Benyass; A Moustaghfir Journal: J Saudi Heart Assoc Date: 2014-08-28
Authors: Douglas S Lee; Philimon Gona; Ramachandran S Vasan; Martin G Larson; Emelia J Benjamin; Thomas J Wang; Jack V Tu; Daniel Levy Journal: Circulation Date: 2009-06-08 Impact factor: 29.690