OBJECTIVES: To quantify the prognostic utility of QRS and QTc interval prolongation in patients presenting with acute destabilised heart failure (ADHF) to the emergency department (ED). DESIGN: Prospective cohort study among patients enrolled in the B-Type Natriuretic Peptide for Acute Shortness of Breath Evaluation (BASEL) study. QRS and QT intervals were measured in 173 consecutive patients with ADHF. QT interval was corrected using the Bazett formula. The primary end point was all-cause mortality during the 720-day follow-up. RESULTS: QRS interval was prolonged (> or =120 ms) in 27% of patients, and QTc interval was prolonged (> or =440 ms) in 72% of patients. Baseline demographic and clinical characteristics were comparable in patients with normal and prolonged QRS or QTc intervals. A total of 78 patients died during follow-up. Interestingly, the 720-day mortality was similar in patients with prolonged and normal QTc (44% vs 42%, p = 0.546), but was significantly higher in patients with prolonged QRS interval than in those with normal QRS (59% vs 37%, p = 0.004). In Cox proportional hazards analysis, prolonged QRS interval was associated with a nearly twofold increase in mortality (HR 1.94, 95% CI 1.22 to 3.07; p = 0.005). This association persisted after adjustment for variables routinely available in the ED. CONCLUSIONS: Prolonged QRS interval, but not prolonged QTc interval, is associated with increased long-term mortality in patients with ADHF.
OBJECTIVES: To quantify the prognostic utility of QRS and QTc interval prolongation in patients presenting with acute destabilised heart failure (ADHF) to the emergency department (ED). DESIGN: Prospective cohort study among patients enrolled in the B-Type Natriuretic Peptide for Acute Shortness of Breath Evaluation (BASEL) study. QRS and QT intervals were measured in 173 consecutive patients with ADHF. QT interval was corrected using the Bazett formula. The primary end point was all-cause mortality during the 720-day follow-up. RESULTS: QRS interval was prolonged (> or =120 ms) in 27% of patients, and QTc interval was prolonged (> or =440 ms) in 72% of patients. Baseline demographic and clinical characteristics were comparable in patients with normal and prolonged QRS or QTc intervals. A total of 78 patients died during follow-up. Interestingly, the 720-day mortality was similar in patients with prolonged and normal QTc (44% vs 42%, p = 0.546), but was significantly higher in patients with prolonged QRS interval than in those with normal QRS (59% vs 37%, p = 0.004). In Cox proportional hazards analysis, prolonged QRS interval was associated with a nearly twofold increase in mortality (HR 1.94, 95% CI 1.22 to 3.07; p = 0.005). This association persisted after adjustment for variables routinely available in the ED. CONCLUSIONS: Prolonged QRS interval, but not prolonged QTc interval, is associated with increased long-term mortality in patients with ADHF.
Authors: M I Anastasiou-Nana; J N Nanas; L A Karagounis; E P Tsagalou; G E Alexopoulos; S Toumanidis; S Gerali; S F Stamatelopoulos; S D Moulopoulos Journal: Am J Cardiol Date: 2000-05-15 Impact factor: 2.778
Authors: P Rossing; L Breum; A Major-Pedersen; A Sato; H Winding; A Pietersen; J Kastrup; H H Parving Journal: Diabet Med Date: 2001-03 Impact factor: 4.359
Authors: S A Hunt; D W Baker; M H Chin; M P Cinquegrani; A M Feldman; G S Francis; T G Ganiats; S Goldstein; G Gregoratos; M L Jessup; R J Noble; M Packer; M A Silver; L W Stevenson; R J Gibbons; E M Antman; J S Alpert; D P Faxon; V Fuster; G Gregoratos; A K Jacobs; L F Hiratzka; R O Russell; S C Smith Journal: Circulation Date: 2001-12-11 Impact factor: 29.690
Authors: Bojan Vrtovec; Reynolds Delgado; Aly Zewail; Cynthia D Thomas; Barbara M Richartz; Branislav Radovancevic Journal: Circulation Date: 2003-03-24 Impact factor: 29.690
Authors: F Follath; J G F Cleland; H Just; J G Y Papp; H Scholz; K Peuhkurinen; V P Harjola; V Mitrovic; M Abdalla; E-P Sandell; L Lehtonen Journal: Lancet Date: 2002-07-20 Impact factor: 79.321
Authors: J G F Cleland; K Swedberg; F Follath; M Komajda; A Cohen-Solal; J C Aguilar; R Dietz; A Gavazzi; R Hobbs; J Korewicki; H C Madeira; V S Moiseyev; I Preda; W H van Gilst; J Widimsky; N Freemantle; Joanne Eastaugh; J Mason Journal: Eur Heart J Date: 2003-03 Impact factor: 29.983
Authors: Kristin Moreth; Luciana Caminha Afonso; Helmut Fuchs; Valérie Gailus-Durner; Hugo A Katus; Raffi Bekeredjian; Lorenz Lehman; Martin Hrabě de Angelis Journal: Int J Cardiovasc Imaging Date: 2015-01-28 Impact factor: 2.357
Authors: Jan Václavík; Jindřich Špinar; David Vindiš; Jiří Vítovec; Petr Widimský; Čestmír Číhalík; Aleš Linhart; Filip Málek; Miloš Táborský; Ladislav Dušek; Jiří Jarkovský; Marián Fedorco; Marián Felšöci; Roman Miklík; Jiří Pařenica Journal: Intern Emerg Med Date: 2012-10-06 Impact factor: 3.397
Authors: Serene Joseph; Mengchen Li; Sicong Zhang; Lloyd Horne; Peter W Stacpoole; Stephanie E Wohlgemuth; Arthur S Edison; Charles Wood; Maureen Keller-Wood Journal: Am J Physiol Regul Integr Comp Physiol Date: 2021-12-01 Impact factor: 3.619
Authors: Parin J Patel; Yuliya Borovskiy; Anthony Killian; Ralph J Verdino; Andrew E Epstein; David J Callans; Francis E Marchlinski; Rajat Deo Journal: Heart Rhythm Date: 2015-11-10 Impact factor: 6.343