Jie Wang1, Jiaqi An2,3, Gary Tse4, Pengcheng He1, Haibo Liu1, Aifeng Zhang5, Guoliang Li2, Yongxin Li6, Chaofeng Sun7, Yang Yan8. 1. Department of Hematology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China. 2. Atrial Fibrillation Centre and Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China. 3. Stroke Centre and Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China. 4. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. 5. Renal Division, Brigham and Women's Hospital, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA, 02115, USA. 6. Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China. 7. Atrial Fibrillation Centre and Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China. cfsun1@xjtu.edu.cn. 8. Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China. yangyan3@xjtu.edu.cn.
Abstract
INTRODUCTION: Patients with multiple myeloma (MM) can develop cardiac abnormalities, predisposing them to the development of heart failure, arrhythmias, or infarction with poor prognosis. The purpose of this study is to evaluate the prognostic potential of electrocardiographic (ECG) parameters in patients with MM. METHODS: This study retrospectively included patients with MM from January 2010 to December 2018 in the First Affiliated Hospital of Xi'an Jiao Tong University. Univariate and multivariate Cox proportional hazard models were conducted to evaluate the relationship between ECG parameters and all-cause mortality in patients with MM. RESULTS: A total of 409 patients were included (mean age 61.3 ± 9.7 years, 59.2% male). The relationship between ECG parameters (including PR interval, voltage, QRS axis, QRS duration, and QTc interval) and all-cause mortality in patients with MM was evaluated. Overall, patients with QTc interval ≥ 400 ms have a significantly higher all-cause mortality compared to those with QTc interval < 400 ms (P < 0.001). When stratified by the International Staging System (ISS), this relationship was true for stages II and III (P < 0.01), but not stage I (P > 0.05). Patients with MM and QRS duration ≥ 120 ms had a higher all-cause mortality compared to those with QRS duration < 120 ms for women (P < 0.01) but not for men (P > 0.05). PR interval, voltage, and QRS axis did not predict mortality. CONCLUSION: QTc interval was independently associated with all-cause mortality in patients with MM, especially when QTc interval was more than 400 ms in more advanced stages II and III. ECG parameters may provide prognostic potential in patients with MM and aid risk stratification of these patients.
INTRODUCTION:Patients with multiple myeloma (MM) can develop cardiac abnormalities, predisposing them to the development of heart failure, arrhythmias, or infarction with poor prognosis. The purpose of this study is to evaluate the prognostic potential of electrocardiographic (ECG) parameters in patients with MM. METHODS: This study retrospectively included patients with MM from January 2010 to December 2018 in the First Affiliated Hospital of Xi'an Jiao Tong University. Univariate and multivariate Cox proportional hazard models were conducted to evaluate the relationship between ECG parameters and all-cause mortality in patients with MM. RESULTS: A total of 409 patients were included (mean age 61.3 ± 9.7 years, 59.2% male). The relationship between ECG parameters (including PR interval, voltage, QRS axis, QRS duration, and QTc interval) and all-cause mortality in patients with MM was evaluated. Overall, patients with QTc interval ≥ 400 ms have a significantly higher all-cause mortality compared to those with QTc interval < 400 ms (P < 0.001). When stratified by the International Staging System (ISS), this relationship was true for stages II and III (P < 0.01), but not stage I (P > 0.05). Patients with MM and QRS duration ≥ 120 ms had a higher all-cause mortality compared to those with QRS duration < 120 ms for women (P < 0.01) but not for men (P > 0.05). PR interval, voltage, and QRS axis did not predict mortality. CONCLUSION: QTc interval was independently associated with all-cause mortality in patients with MM, especially when QTc interval was more than 400 ms in more advanced stages II and III. ECG parameters may provide prognostic potential in patients with MM and aid risk stratification of these patients.
Authors: Krati Chauhan; Michael J Ackerman; Cynthia S Crowson; Eric L Matteson; Sherine E Gabriel Journal: Clin Exp Rheumatol Date: 2015-01-08 Impact factor: 4.473