BACKGROUND: The role of QTc interval prolongation in heart failure remains poorly defined. To better understand it, we analyzed the QTc interval duration in patients with heart failure with high B-type natriuretic peptide (BNP) levels and analyzed the combined prognostic impact of prolonged QTc and elevated BNP. METHODS AND RESULTS: QTc intervals were measured in 241 patients with heart failure who had BNP levels >400 pg/mL. QT interval duration was determined by averaging 3 consecutive beats through leads II and V4 on a standard 12-lead ECG and corrected by using the Bazett formula. QTc intervals were prolonged (>440 ms) in 122 (51%) patients and normal in 119 (49%). The BNP levels in these 2 groups were not significantly different (786+/-321 pg/mL in the prolonged QTc group versus 733+/-274 pg/mL in the normal QTc group, P=0.13). During 6 months of follow-up, 46 patients died, 9 underwent transplantation, and 17 underwent left ventricular assist device implantation. The deaths were attributed to pump failure (n=24, 52%), sudden cardiac death (n=18, 39%), or noncardiac causes (n=4, 9%). Kaplan-Meier survival rates were 3 times higher in the normal QTc group than in the prolonged QTc group (P<0.0001). On multivariate analysis, prolonged QTc interval was an independent predictor of all-cause death (P=0.0001), cardiac death (P=0.0001), sudden cardiac death (P=0.004), and pump failure death (P=0.0006). CONCLUSIONS: Prolonged QTc interval is a strong, independent predictor of adverse outcome in patients with heart failure with BNP levels >400 pg/mL.
BACKGROUND: The role of QTc interval prolongation in heart failure remains poorly defined. To better understand it, we analyzed the QTc interval duration in patients with heart failure with high B-type natriuretic peptide (BNP) levels and analyzed the combined prognostic impact of prolonged QTc and elevated BNP. METHODS AND RESULTS:QTc intervals were measured in 241 patients with heart failure who had BNP levels >400 pg/mL. QT interval duration was determined by averaging 3 consecutive beats through leads II and V4 on a standard 12-lead ECG and corrected by using the Bazett formula. QTc intervals were prolonged (>440 ms) in 122 (51%) patients and normal in 119 (49%). The BNP levels in these 2 groups were not significantly different (786+/-321 pg/mL in the prolonged QTc group versus 733+/-274 pg/mL in the normal QTc group, P=0.13). During 6 months of follow-up, 46 patients died, 9 underwent transplantation, and 17 underwent left ventricular assist device implantation. The deaths were attributed to pump failure (n=24, 52%), sudden cardiac death (n=18, 39%), or noncardiac causes (n=4, 9%). Kaplan-Meier survival rates were 3 times higher in the normal QTc group than in the prolonged QTc group (P<0.0001). On multivariate analysis, prolonged QTc interval was an independent predictor of all-cause death (P=0.0001), cardiac death (P=0.0001), sudden cardiac death (P=0.004), and pump failure death (P=0.0006). CONCLUSIONS: Prolonged QTc interval is a strong, independent predictor of adverse outcome in patients with heart failure with BNP levels >400 pg/mL.
Authors: Robert E Eckart; Mark W Kolasa; Nancy A Khan; Michael D Kwan; Mark E Peele Journal: Ann Noninvasive Electrocardiol Date: 2005-01 Impact factor: 1.468
Authors: Bojan Vrtovec; Aria P Ryazdanbakhsh; Tatjana Pintar; Charles D Collard; Igor D Gregoric; Branislav Radovancevic Journal: Tex Heart Inst J Date: 2006
Authors: W H Linda Kao; Dan E Arking; Wendy Post; Thomas D Rea; Nona Sotoodehnia; Ronald J Prineas; Bryan Bishe; Betty Q Doan; Eric Boerwinkle; Bruce M Psaty; Gordon F Tomaselli; Josef Coresh; David S Siscovick; Eduardo Marbán; Peter M Spooner; Gregory L Burke; Aravinda Chakravarti Journal: Circulation Date: 2009-02-09 Impact factor: 29.690
Authors: J Michael Frangiskakis; Marilyn Hravnak; Elizabeth A Crago; Masaki Tanabe; Kevin E Kip; John Gorcsan; Michael B Horowitz; Amin B Kassam; Barry London Journal: Neurocrit Care Date: 2009-01-28 Impact factor: 3.210
Authors: Vinzenz Hombach; Nico Merkle; Jan Torzewski; Johann M Kraus; Markus Kunze; Oliver Zimmermann; Hans A Kestler; Jochen Wöhrle Journal: Eur Heart J Date: 2009-07-24 Impact factor: 29.983