Clinical characteristics and survival of patients with chronic heart failure and prolonged QRS duration

Paul R. Kalra, Rakesh Sharma, Waqar Shamim, Wolfram Doehner, Roland Wensel, Aidan P. Bolger, Sabine Genth-Zotz, Mariantonietta Cicoira, Andrew J S Coats, Stefan D. Anker

Research output: Contribution to journalArticle

Abstract

Background: Abnormal prolongation of QRS duration is a common finding in patients with chronic heart failure, and is associated with an impaired prognosis. The optimum QRS duration for separating chronic heart failure patients with respect to prognosis has not been determined. Whilst resynchronisation of ventricular conduction may benefit patients with QRS>150 ms, this has yet to be determined for patients with moderate QRS prolongation. Methods: We evaluated 155 patients with chronic heart failure (New York Heart Association class 2.6±0.8, mean±S.D.). The mean follow-up period was 838±748 days. Patients were sub-grouped according to QRS duration: 150 ms (severe prolongation, n=29). Results: The optimal QRS duration for stratifying patients for 2-year event free survival was 120 ms (receiver operating characteristic analysis: area under curve 0.73; 95% CI 0.64-0.81). Moderate prolongation of QRS duration was associated with a worse New York Heart Association class, peak oxygen consumption and left ventricular ejection fraction when compared to patients with normal QRS duration (all P150 ms (all P >150). Conclusions: The optimum QRS duration for stratifying patients for medium to long-term event-free survival was 120 ms. Heart failure patients with moderate QRS prolongation share similar impairment of exercise capacity and functional class to those with severe prolongation.

Original languageEnglish
Pages (from-to)225-231
Number of pages7
JournalInternational Journal of Cardiology
Volume86
Issue number2-3
DOIs
Publication statusPublished - Dec 2002

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Kalra, P. R., Sharma, R., Shamim, W., Doehner, W., Wensel, R., Bolger, A. P., Genth-Zotz, S., Cicoira, M., Coats, A. J. S., & Anker, S. D. (2002). Clinical characteristics and survival of patients with chronic heart failure and prolonged QRS duration. International Journal of Cardiology, 86(2-3), 225-231. https://doi.org/10.1016/S0167-5273(02)00270-X