Abstract
Chronic heart failure (CHF) is associated with high mortality, and there are several established clinical and laboratory parameters that predict mortality in CHF. The purpose of this study was (a) to identify the best ECG parameter that predicts mortality, (b) to evaluate the prognostic marker of ECG against well-established indicators of prognosis. Relevant data from 241 CHF patients were analysed retrospectively. Cardiopulmonary exercise testing and radionuclide ventriculogram were also performed where possible. The mean follow-up period was 31 months. On univariate analysis by the Cox proportional Hazard method, intraventricular conduction delay (IVCD) [P <0.0001, hazard ratio 1.017 (1.011-1.024)] and QTc [P <0.0001, hazard ratio 1.012 (1.006-1.017)] were identified as predictors of mortality. On bivariate analysis, IVCD and MVO2 were better predictors when combined together. A model based on multivariate analysis showed that IVCD, MVO2 and left ventricular ejection fraction (LVEF) were the best predictors of mortality. The addition of plasma sodium, age and NYHA class had no added benefit on the predictive power of the model. Further analysis of IVCD and QTc showed that, for different cut-off values, IVCD is better than QTc, and that there is a graded increase in mortality with increasing value of IVCD. We have found that IVCD is an important ECG predictor of prognosis in patients with CHF.
| Original language | English |
|---|---|
| Pages (from-to) | 171-178 |
| Number of pages | 8 |
| Journal | International Journal of Cardiology |
| Volume | 70 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Jul 31 1999 |
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Keywords
- Electrocardiography
- Heart failure
- Mortality
- Prognosis
- Survival
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Intraventricular conduction delay : A prognostic marker in chronic heart failure. / Shamim, Waqar; Francis, Darrel P.; Yousufuddin, Mohammed; Varney, Susan; Pieopli, Masimo F.; Anker, Stefan D.; Coats, Andrew J S.
In: International Journal of Cardiology, Vol. 70, No. 2, 31.07.1999, p. 171-178.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intraventricular conduction delay
T2 - A prognostic marker in chronic heart failure
AU - Shamim, Waqar
AU - Francis, Darrel P.
AU - Yousufuddin, Mohammed
AU - Varney, Susan
AU - Pieopli, Masimo F.
AU - Anker, Stefan D.
AU - Coats, Andrew J S
PY - 1999/7/31
Y1 - 1999/7/31
N2 - Chronic heart failure (CHF) is associated with high mortality, and there are several established clinical and laboratory parameters that predict mortality in CHF. The purpose of this study was (a) to identify the best ECG parameter that predicts mortality, (b) to evaluate the prognostic marker of ECG against well-established indicators of prognosis. Relevant data from 241 CHF patients were analysed retrospectively. Cardiopulmonary exercise testing and radionuclide ventriculogram were also performed where possible. The mean follow-up period was 31 months. On univariate analysis by the Cox proportional Hazard method, intraventricular conduction delay (IVCD) [P <0.0001, hazard ratio 1.017 (1.011-1.024)] and QTc [P <0.0001, hazard ratio 1.012 (1.006-1.017)] were identified as predictors of mortality. On bivariate analysis, IVCD and MVO2 were better predictors when combined together. A model based on multivariate analysis showed that IVCD, MVO2 and left ventricular ejection fraction (LVEF) were the best predictors of mortality. The addition of plasma sodium, age and NYHA class had no added benefit on the predictive power of the model. Further analysis of IVCD and QTc showed that, for different cut-off values, IVCD is better than QTc, and that there is a graded increase in mortality with increasing value of IVCD. We have found that IVCD is an important ECG predictor of prognosis in patients with CHF.
AB - Chronic heart failure (CHF) is associated with high mortality, and there are several established clinical and laboratory parameters that predict mortality in CHF. The purpose of this study was (a) to identify the best ECG parameter that predicts mortality, (b) to evaluate the prognostic marker of ECG against well-established indicators of prognosis. Relevant data from 241 CHF patients were analysed retrospectively. Cardiopulmonary exercise testing and radionuclide ventriculogram were also performed where possible. The mean follow-up period was 31 months. On univariate analysis by the Cox proportional Hazard method, intraventricular conduction delay (IVCD) [P <0.0001, hazard ratio 1.017 (1.011-1.024)] and QTc [P <0.0001, hazard ratio 1.012 (1.006-1.017)] were identified as predictors of mortality. On bivariate analysis, IVCD and MVO2 were better predictors when combined together. A model based on multivariate analysis showed that IVCD, MVO2 and left ventricular ejection fraction (LVEF) were the best predictors of mortality. The addition of plasma sodium, age and NYHA class had no added benefit on the predictive power of the model. Further analysis of IVCD and QTc showed that, for different cut-off values, IVCD is better than QTc, and that there is a graded increase in mortality with increasing value of IVCD. We have found that IVCD is an important ECG predictor of prognosis in patients with CHF.
KW - Electrocardiography
KW - Heart failure
KW - Mortality
KW - Prognosis
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=0033620875&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033620875&partnerID=8YFLogxK
U2 - 10.1016/S0167-5273(99)00077-7
DO - 10.1016/S0167-5273(99)00077-7
M3 - Article
C2 - 10454306
AN - SCOPUS:0033620875
VL - 70
SP - 171
EP - 178
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 2
ER -