Relation of dispersion of QRS and QT in patients with advanced congestive heart failure to cardiac and sudden death mortality
Section snippets
Methods
Candidates for inclusion in this study were all patients in New York Heart Association (NYHA) functional classes II to IV, and with a LV ejection fraction of <35%, admitted to our institution’s outpatient department for management of CHF.
Exclusion criteria included age ≥75 years, pregnancy, heart failure secondary to hypertrophic or restrictive cardiomyopathy, constrictive pericarditis, congenital heart disease, mitral and aortic stenosis, right-sided cardiac failure secondary to pulmonary
Results
The demographic and electrocardiographic characteristics of 104 patients who satisfied the criteria for entry into the study are presented in TABLE I, TABLE II. There were 87 men and 17 women, and mean age was 52.6 ± 12.9 years (range 18 to 74). All suffered from symptomatic LV systolic dysfunction secondary to ischemic heart disease (n = 45) or idiopathic dilated cardiomyopathy (n = 59). Mean LV ejection fraction determined by radionuclide ventriculography was 22 ± 10% and mean NYHA functional
Study summary and implications
The results of the present study10, 11 demonstrate a substantial mortality risk in patients with advanced CHF and pronounced dispersion of ventricular repolarization. In addition, this study, to our knowledge, is the first to describe a relation between interlead variability of QRS measured in the standard 12-lead electrocardiogram and subsequent mortality in patients with severe CHF. An increased interlead variability in intraventricular conduction (QRS dispersion) identified a group of
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2017, Cardiac Electrophysiology ClinicsCitation Excerpt :QRS dispersion (QRS-D) is the maximum difference between QRS duration between the right and left precordial leads. QRS-D has been shown to predict mortality and sudden cardiac death in patients with advanced congestive heart failure.66 QRS-D has also been compared against Qt dispersion, syncope, and negative T waves beyond V1 in a population of patients with arrhythmogenic right ventricular cardiomyopathy and was found to be significantly superior in predicting sudden cardiac death.67,68
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2012, American Heart JournalCitation Excerpt :Although prior studies of the QT interval in chronic kidney disease have largely focused on the end-stage renal disease population,22-24 it appears that even milder forms of renal dysfunction confer adverse effects on the QT interval in a graded fashion, with decreasing GFR. In addition, although the negative prognostic implications of QT prolongation in heart failure have been established in prior investigations,25-27 that QTc interval prolongation was associated with worsening NYHA class and lower ejection fraction is a novel finding. To date, this is the largest population-based study, of which we are aware, of the prevalence, associated clinical factors, and outcomes of patients with QTc interval prolongation and CAD.
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