Prognostic implications of QRS dispersion for major adverse cardiovascular events in asymptomatic women and men: the Multi-Ethnic Study of Atherosclerosis

被引:3
作者
Jain, Rahul [1 ,2 ]
Gautam, Sandeep [3 ]
Wu, Colin [2 ,4 ]
Shen, Changyu [5 ,6 ]
Jain, Aditya [2 ]
Giesdal, Ola [2 ]
Chahal, Harjit [2 ]
Lin, Hongbo [5 ,6 ]
Bluemke, David A. [7 ]
Soliman, Elsayed Z. [8 ,9 ]
Nazarian, Saman [2 ]
Lima, Joao A. C. [2 ]
机构
[1] Indiana Univ Sch Med, Dept Cardiol, Krannert Inst Cardiol, 1800 N Capitol Ave, Indianapolis, IN 46202 USA
[2] Johns Hopkins Sch Med, Div Cardiol, Baltimore, MD USA
[3] Univ Missouri, Div Cardiovasc Med, Columbia, MO USA
[4] NHLBI, Off Biostat Res, Bldg 10, Bethesda, MD 20892 USA
[5] Indiana Univ, Dept Biostat, Sch Med, Indianapolis, IN 46204 USA
[6] Indiana Univ, Richard M Fairbanks Sch Publ Hlth, Indianapolis, IN 46204 USA
[7] NIH, Radiol & Imaging Sci, Bldg 10, Bethesda, MD 20892 USA
[8] Wake Forest Sch Med, Epidemiol Cardiol Res Ctr, Dept Epidemiol & Prevent, Winston Salem, NC 27101 USA
[9] Wake Forest Sch Med, Cardiol Sect, Dept Internal Med, Winston Salem, NC 27101 USA
关键词
QRS dispersion; Mortality; Major adverse cardiovascular events; Multi-Ethnic Study of Atherosclerosis; Heart failure; CONGESTIVE-HEART-FAILURE; LEFT-VENTRICULAR MASS; NONUNIFORM RECOVERY; RISK STRATIFICATION; QT-INTERVAL; INDEX; EXCITABILITY; ARRHYTHMIAS; DISEASE; MARKER;
D O I
10.1007/s10840-019-00614-y
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background QRS dispersion measured as the difference between maximal and minimal QRS duration in the standard 12-lead electrocardiogram has been shown to be associated with increased mortality in heart failure (HF) patients and increased arrhythmic events in patients with cardiomyopathy. Aims This study sought to examine the prognostic association between baseline QRS dispersion and future cardiovascular events in individuals without known prior cardiovascular disease. Methods The association of QRS dispersion with cardiovascular events was examined in 6510 MESA (Multi-Ethnic Study of Atherosclerosis) participants. Participants with bundle branch block were excluded. Study participants were divided into two groups based on the 95th percentile of QRS dispersion (QRS dispersion < 34 ms [group I] and QRS dispersion >= 34 ms [group II]). Cox proportional hazard models adjusting for demographic and clinical risk factors were used to examine the association of QRS dispersion with incident cardiovascular events (major adverse cardiovascular events [MACE]) and mortality. Analysis was repeated by forcing Framingham risk factors. Results Mean age was 62 +/- 10 years in group I and 63 +/- 10 years in group II (P = 0.02). QRS dispersion >= 34 ms was associated significantly with MACE (HR 1.30; 95% CI 1.04-1.62) and mortality (HR 1.33; 95% CI 1.03-1.73) after adjustment for cardiovascular risk factors and potential cofounders. Similar results were seen for mortality after adjustment for Framingham risk factors. Conclusion QRS dispersion >= 34 ms predicts cardiovascular events and mortality.
引用
收藏
页码:45 / 53
页数:9
相关论文
共 25 条
[1]   Electrocardiographic predictive factors of long-term clinical improvement with multisite biventricular pacing in advanced heart failure [J].
Alonso, C ;
Leclercq, C ;
Victor, F ;
Mansour, H ;
de Place, C ;
Pavin, D ;
Carré, F ;
Mabo, P ;
Daubert, JC .
AMERICAN JOURNAL OF CARDIOLOGY, 1999, 84 (12) :1417-1421
[2]   Relation of dispersion of QRS and QT in patients with advanced congestive heart failure to cardiac and sudden death mortality [J].
Anastasiou-Nana, MI ;
Nanas, JN ;
Karagounis, LA ;
Tsagalou, EP ;
Alexopoulos, GE ;
Toumanidis, S ;
Gerali, S ;
Stamatelopoulos, SF ;
Moulopoulos, SD .
AMERICAN JOURNAL OF CARDIOLOGY, 2000, 85 (10) :1212-1217
[3]   CONGESTIVE-HEART-FAILURE, CORONARY EVENTS AND ATHEROTHROMBOTIC BRAIN INFARCTION IN ELDERLY BLACKS AND WHITES WITH SYSTEMIC HYPERTENSION AND WITH AND WITHOUT ECHOCARDIOGRAPHIC AND ELECTROCARDIOGRAPHIC EVIDENCE OF LEFT-VENTRICULAR HYPERTROPHY [J].
ARONOW, WS ;
AHN, C ;
KRONZON, I ;
KOENIGSBERG, M .
AMERICAN JOURNAL OF CARDIOLOGY, 1991, 67 (04) :295-299
[4]   Multi-ethnic study of atherosclerosis: Objectives and design [J].
Bild, DE ;
Bluemke, DA ;
Burke, GL ;
Detrano, R ;
Roux, AVD ;
Folsom, AR ;
Greenland, P ;
Jacobs, DR ;
Kronmal, R ;
Liu, K ;
Nelson, JC ;
O'Leary, D ;
Saad, MF ;
Shea, S ;
Szklo, M ;
Tracy, RP .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2002, 156 (09) :871-881
[5]   The Relationship of Left Ventricular Mass and Geometry to Incident Cardiovascular Events [J].
Bluemke, David A. ;
Kronmal, Richard A. ;
Lima, Joao A. C. ;
Liu, Kiang ;
Olson, Jean ;
Burke, Gregory L. ;
Folsom, Aaron R. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2008, 52 (25) :2148-2155
[6]  
Bonow RO, 2008, J AM COLL CARDIOL, V52, pE1, DOI [10.1016/j.jacc.2008.05.007, 10.1016/j.hrthm.2008.04.014, 10.1016/j.jacc.2008.02.032]
[7]   ENDOCARDIAL MAPPING IN HUMANS IN SINUS RHYTHM WITH NORMAL LEFT-VENTRICLES - ACTIVATION PATTERNS AND CHARACTERISTICS OF ELECTROGRAMS [J].
CASSIDY, DM ;
VASSALLO, JA ;
MARCHLINSKI, FE ;
BUXTON, AE ;
UNTEREKER, WJ ;
JOSEPHSON, ME .
CIRCULATION, 1984, 70 (01) :37-42
[8]   Prognostic value of myocardial circumferential strain for incident heart failure and cardiovascular events in asymptomatic individuals: the Multi-Ethnic Study of Atherosclerosis [J].
Choi, Eui-Young ;
Rosen, Boaz D. ;
Fernandes, Veronica R. S. ;
Yan, Raymond T. ;
Yoneyama, Kihei ;
Donekal, Sirisha ;
Opdahl, Anders ;
Almeida, Andre L. C. ;
Wu, Colin O. ;
Gomes, Antoinette S. ;
Bluemke, David A. ;
Lima, Joao A. C. .
EUROPEAN HEART JOURNAL, 2013, 34 (30) :2354-2361
[9]   TOTAL EXCITATION OF ISOLATED HUMAN HEART [J].
DURRER, D ;
VANDAM, RT ;
FREUD, GE ;
JANSE, MJ ;
MEIJLER, FL ;
ARZBAECHER, RC .
CIRCULATION, 1970, 41 (06) :899-+
[10]   QT-INTERVAL DISPERSION ON 12-LEAD ELECTROCARDIOGRAM IN NORMAL SUBJECTS - ITS REPRODUCIBILITY AND RELATION TO THE T-WAVE [J].
FEI, L ;
STATTERS, DJ ;
CAMM, AJ .
AMERICAN HEART JOURNAL, 1994, 127 (06) :1654-1655