OBJECTIVE: Longer QRS duration on the ECG is associated with increased cardiovascular (CV) mortality. To evaluate potential mechanisms, we examined in this study the relationship between QRS duration and left ventricular (LV) mass and LV end systolic and end diastolic volume in patients with known CV disease or high-risk diabetes. METHODS: In a substudy of the ONTARGET/TRANSCEND (Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomised Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease) clinical trials, 368 patients had a cardiac magnetic resonance scan to measure LV mass, LV end systolic volume, LV end diastolic volume and LV ejection fraction at baseline and after 2 years of follow-up. Relationships between QRS duration on the 12-lead ECG and LV mass and volumes were evaluated at both assessments. RESULTS: Each 10-ms increase in QRS duration both within and above the normal reference range was associated with an 8.3% (95% CI 6.7% to 9.9%) increase in LV mass, a 9.2% (95% CI 7.4% to 10%) increase in LV end diastolic volume and a 7.8% (95% CI 6.4% to 9.3%) increase in LV end systolic volume. QRS duration increased with body size, but associations with LV mass and volumes remained strong after indexing measurements to height(2.7) (p<0.001 for all) and were similar for subjects with an otherwise normal and abnormal ECG. CONCLUSION: A longer QRS duration both within and above the normal reference range is associated with a greater LV mass and larger LV end systolic and end diastolic volumes. This may explain the known association of longer QRS duration with increased CV mortality.
RCT Entities:
OBJECTIVE: Longer QRS duration on the ECG is associated with increased cardiovascular (CV) mortality. To evaluate potential mechanisms, we examined in this study the relationship between QRS duration and left ventricular (LV) mass and LV end systolic and end diastolic volume in patients with known CV disease or high-risk diabetes. METHODS: In a substudy of the ONTARGET/TRANSCEND (Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomised Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease) clinical trials, 368 patients had a cardiac magnetic resonance scan to measure LV mass, LV end systolic volume, LV end diastolic volume and LV ejection fraction at baseline and after 2 years of follow-up. Relationships between QRS duration on the 12-lead ECG and LV mass and volumes were evaluated at both assessments. RESULTS: Each 10-ms increase in QRS duration both within and above the normal reference range was associated with an 8.3% (95% CI 6.7% to 9.9%) increase in LV mass, a 9.2% (95% CI 7.4% to 10%) increase in LV end diastolic volume and a 7.8% (95% CI 6.4% to 9.3%) increase in LV end systolic volume. QRS duration increased with body size, but associations with LV mass and volumes remained strong after indexing measurements to height(2.7) (p<0.001 for all) and were similar for subjects with an otherwise normal and abnormal ECG. CONCLUSION: A longer QRS duration both within and above the normal reference range is associated with a greater LV mass and larger LV end systolic and end diastolic volumes. This may explain the known association of longer QRS duration with increased CV mortality.
Authors: Tor Biering-Sørensen; Muammar Kabir; Jonathan W Waks; Jason Thomas; Wendy S Post; Elsayed Z Soliman; Alfred E Buxton; Amil M Shah; Scott D Solomon; Larisa G Tereshchenko Journal: Circ Arrhythm Electrophysiol Date: 2018-03
Authors: Dulciana D Chan; Katherine C Wu; Zak Loring; Loriano Galeotti; Gary Gerstenblith; Gordon Tomaselli; Robert G Weiss; Galen S Wagner; David G Strauss Journal: Am J Cardiol Date: 2014-03-02 Impact factor: 2.778
Authors: Maren Maanja; Björn Wieslander; Todd T Schlegel; Ljuba Bacharova; Hussein Abu Daya; Yaron Fridman; Timothy C Wong; Erik B Schelbert; Martin Ugander Journal: J Am Heart Assoc Date: 2017-01-22 Impact factor: 5.501
Authors: Niraj Varma; Peter Sogaard; Jeroen J Bax; William T Abraham; Jeffrey S Borer; Kenneth Dickstein; Jagmeet P Singh; Daniel Gras; Johannes Holzmeister; Josep Brugada; Frank Ruschitzka Journal: J Am Heart Assoc Date: 2018-05-27 Impact factor: 5.501
Authors: Floran Sahiti; Caroline Morbach; Vladimir Cejka; Judith Albert; Felizitas A Eichner; Götz Gelbrich; Peter U Heuschmann; Stefan Störk Journal: Front Cardiovasc Med Date: 2021-06-11