Document Detail

Prognostic importance of change in QRS duration over time associated with left ventricular dysfunction in patients with congestive heart failure: the DIAMOND study.
MedLine Citation:
PMID:  19041049     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The prognostic importance reported for QRS duration in patients with heart failure (HF) and left ventricular dysfunction varies. No prior study has investigated the prognostic importance of change in QRS duration over time. METHODS AND RESULTS: The Danish Investigations and Arrhythmia ON Dofetilide (DIAMOND) study randomized 1518 patients with HF to dofetilide (class III antiarrhythmic drug) or placebo. All patients had left ventricular dysfunction. QRS duration was systematically measured at randomization and every 3 months after that. During 10 years of follow-up, 1324 (89%) of the patients died. QRS duration increased from baseline by 1.36 ms (95% confidence interval [CI]: -0.26 to -2.98; P = .1) after 12 months and by 3.65 ms (CI: 0.22-7.07; P = .04) after 24 months. QRS duration measured at baseline was not of prognostic significance after multivariable adjustment (adjusted hazard ratio [HR] 1.01, CI: 0.99-1.04; P = .2 per 10-ms increment in QRS duration). The adjusted relative risk associated with a 10-ms increase in QRS duration over time was 2% (HR 1.02, CI: 1.01-1.04; P = .03). A 10-ms increment in QRS 12 months after randomization was associated with a HR of 1.05 (CI: 1.00-1.09; P = .03). CONCLUSIONS: In patients with left ventricular dysfunction and HF, QRS duration increased over time and the increase was associated with increasing mortality.
Emil Loldrup Fosbøl; Marie Seibaek; Bente Brendorp; Christian Torp-Pedersen; Lars Køber;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-09-06
Journal Detail:
Title:  Journal of cardiac failure     Volume:  14     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-01     Completed Date:  2009-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  850-5     Citation Subset:  IM    
The Heart Centre, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
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MeSH Terms
Aged, 80 and over
Denmark / epidemiology
Double-Blind Method
Follow-Up Studies
Heart Failure / diagnosis*,  mortality,  physiopathology*
Heart Rate / physiology*
Middle Aged
Survival Rate / trends
Time Factors
Ventricular Dysfunction, Left / diagnosis*,  mortality,  physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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