Prognostic Value of QRS Duration in Patients with Dilated Cardiomyopathy According to Left Ventricular Ejection Fraction
Background: The prognostic significance of QRS duration (QRSd) in patients with dilated cardiomyopathy (DCM) and a left ventricular ejection fraction (LVEF) between 30% and 50% is unclear, resulting in questions regarding eligibility for cardiac resynchronisation therapy. This study aimed to explore...
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| Format: | Article |
| Language: | English |
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IMR Press
2023-12-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/24/12/10.31083/j.rcm2412362 |
| _version_ | 1797365323667603456 |
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| author | Jiayu Feng Xuemei Zhao Boping Huang Yihang Wu Jing Wang Jingyuan Guan Liyan Huang Xinqing Li Yuhui Zhang Jian Zhang |
| author_facet | Jiayu Feng Xuemei Zhao Boping Huang Yihang Wu Jing Wang Jingyuan Guan Liyan Huang Xinqing Li Yuhui Zhang Jian Zhang |
| author_sort | Jiayu Feng |
| collection | DOAJ |
| description | Background: The prognostic significance of QRS duration (QRSd) in patients with dilated cardiomyopathy (DCM) and a left ventricular ejection fraction (LVEF) between 30% and 50% is unclear, resulting in questions regarding eligibility for cardiac resynchronisation therapy. This study aimed to explore the prognostic role of QRSd in patients with DCM and a LVEF 30–50% or LVEF <30%. Methods: Patients hospitalised at Fuwai hospital with DCM who had a LVEF ≤50% were prospectively included. The primary outcomes were a composite of death, heart transplantation, and rehospitalisation for worsening heart failure. Results: Among the 633 patients included, 302 (47.7%) had a LVEF of 30–50%. The multivariable hazard ratio (HR) for QRSd ≥120 ms was 1.65 (95% confidence interval [CI] 1.29–2.11, p < 0.001) for overall DCM patients, 2.8 (95% CI 1.82–4.30, p < 0.001) for patients with LVEF 30–50%, and 1.41 (95% CI 1.02–1.94, p = 0.036) for patients with LVEF <30%. QRSd ≥120 ms tended to be more strongly associated with outcome in patients with LVEF 30–50% than in those with LVEF <30% despite the non-significant interaction (p = 0.067). DCM patients with QRSd ≥120 ms and LVEF 30–50% did not experience a significantly better outcome than those with LVEF <30% and QRSd <120 ms after propensity-score matching (HR 0.91, 95% CI 0.61–1.36, p = 0.645). Conclusions: QRSd independently predicts prognosis in DCM patients irrespective of LVEF and identifies a group of high-risk patients who may benefit from device implantation despite the absence of severely reduced LVEF. |
| first_indexed | 2024-03-08T16:47:29Z |
| format | Article |
| id | doaj.art-d8081bc7a78e46b291cede9bc29b82c4 |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-03-08T16:47:29Z |
| publishDate | 2023-12-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-d8081bc7a78e46b291cede9bc29b82c42024-01-05T09:04:30ZengIMR PressReviews in Cardiovascular Medicine1530-65502023-12-01241236210.31083/j.rcm2412362S1530-6550(23)01097-9Prognostic Value of QRS Duration in Patients with Dilated Cardiomyopathy According to Left Ventricular Ejection FractionJiayu Feng0Xuemei Zhao1Boping Huang2Yihang Wu3Jing Wang4Jingyuan Guan5Liyan Huang6Xinqing Li7Yuhui Zhang8Jian Zhang9State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 10000 Beijing, ChinaState Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 10000 Beijing, ChinaState Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 10000 Beijing, ChinaState Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 10000 Beijing, ChinaState Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 10000 Beijing, ChinaState Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 10000 Beijing, ChinaState Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 10000 Beijing, ChinaState Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 10000 Beijing, ChinaState Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 10000 Beijing, ChinaState Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 10000 Beijing, ChinaBackground: The prognostic significance of QRS duration (QRSd) in patients with dilated cardiomyopathy (DCM) and a left ventricular ejection fraction (LVEF) between 30% and 50% is unclear, resulting in questions regarding eligibility for cardiac resynchronisation therapy. This study aimed to explore the prognostic role of QRSd in patients with DCM and a LVEF 30–50% or LVEF <30%. Methods: Patients hospitalised at Fuwai hospital with DCM who had a LVEF ≤50% were prospectively included. The primary outcomes were a composite of death, heart transplantation, and rehospitalisation for worsening heart failure. Results: Among the 633 patients included, 302 (47.7%) had a LVEF of 30–50%. The multivariable hazard ratio (HR) for QRSd ≥120 ms was 1.65 (95% confidence interval [CI] 1.29–2.11, p < 0.001) for overall DCM patients, 2.8 (95% CI 1.82–4.30, p < 0.001) for patients with LVEF 30–50%, and 1.41 (95% CI 1.02–1.94, p = 0.036) for patients with LVEF <30%. QRSd ≥120 ms tended to be more strongly associated with outcome in patients with LVEF 30–50% than in those with LVEF <30% despite the non-significant interaction (p = 0.067). DCM patients with QRSd ≥120 ms and LVEF 30–50% did not experience a significantly better outcome than those with LVEF <30% and QRSd <120 ms after propensity-score matching (HR 0.91, 95% CI 0.61–1.36, p = 0.645). Conclusions: QRSd independently predicts prognosis in DCM patients irrespective of LVEF and identifies a group of high-risk patients who may benefit from device implantation despite the absence of severely reduced LVEF.https://www.imrpress.com/journal/RCM/24/12/10.31083/j.rcm2412362dilated cardiomyopathycardiac resynchronization therapyprognosiselectrocardiography |
| spellingShingle | Jiayu Feng Xuemei Zhao Boping Huang Yihang Wu Jing Wang Jingyuan Guan Liyan Huang Xinqing Li Yuhui Zhang Jian Zhang Prognostic Value of QRS Duration in Patients with Dilated Cardiomyopathy According to Left Ventricular Ejection Fraction Reviews in Cardiovascular Medicine dilated cardiomyopathy cardiac resynchronization therapy prognosis electrocardiography |
| title | Prognostic Value of QRS Duration in Patients with Dilated Cardiomyopathy According to Left Ventricular Ejection Fraction |
| title_full | Prognostic Value of QRS Duration in Patients with Dilated Cardiomyopathy According to Left Ventricular Ejection Fraction |
| title_fullStr | Prognostic Value of QRS Duration in Patients with Dilated Cardiomyopathy According to Left Ventricular Ejection Fraction |
| title_full_unstemmed | Prognostic Value of QRS Duration in Patients with Dilated Cardiomyopathy According to Left Ventricular Ejection Fraction |
| title_short | Prognostic Value of QRS Duration in Patients with Dilated Cardiomyopathy According to Left Ventricular Ejection Fraction |
| title_sort | prognostic value of qrs duration in patients with dilated cardiomyopathy according to left ventricular ejection fraction |
| topic | dilated cardiomyopathy cardiac resynchronization therapy prognosis electrocardiography |
| url | https://www.imrpress.com/journal/RCM/24/12/10.31083/j.rcm2412362 |
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