Document Detail


Prolonged QTc interval and high B-type natriuretic peptide levels together predict mortality in patients with advanced heart failure.
MedLine Citation:
PMID:  12665499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The role of QTc interval prolongation in heart failure remains poorly defined. To better understand it, we analyzed the QTc interval duration in patients with heart failure with high B-type natriuretic peptide (BNP) levels and analyzed the combined prognostic impact of prolonged QTc and elevated BNP. METHODS AND RESULTS: QTc intervals were measured in 241 patients with heart failure who had BNP levels >400 pg/mL. QT interval duration was determined by averaging 3 consecutive beats through leads II and V4 on a standard 12-lead ECG and corrected by using the Bazett formula. QTc intervals were prolonged (>440 ms) in 122 (51%) patients and normal in 119 (49%). The BNP levels in these 2 groups were not significantly different (786+/-321 pg/mL in the prolonged QTc group versus 733+/-274 pg/mL in the normal QTc group, P=0.13). During 6 months of follow-up, 46 patients died, 9 underwent transplantation, and 17 underwent left ventricular assist device implantation. The deaths were attributed to pump failure (n=24, 52%), sudden cardiac death (n=18, 39%), or noncardiac causes (n=4, 9%). Kaplan-Meier survival rates were 3 times higher in the normal QTc group than in the prolonged QTc group (P<0.0001). On multivariate analysis, prolonged QTc interval was an independent predictor of all-cause death (P=0.0001), cardiac death (P=0.0001), sudden cardiac death (P=0.004), and pump failure death (P=0.0006). CONCLUSIONS: Prolonged QTc interval is a strong, independent predictor of adverse outcome in patients with heart failure with BNP levels >400 pg/mL.
Authors:
Bojan Vrtovec; Reynolds Delgado; Aly Zewail; Cynthia D Thomas; Barbara M Richartz; Branislav Radovancevic
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Publication Detail:
Type:  Journal Article     Date:  2003-03-24
Journal Detail:
Title:  Circulation     Volume:  107     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-08     Completed Date:  2003-04-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1764-9     Citation Subset:  AIM; IM    
Affiliation:
Heart Failure Center, Texas Heart Institute at St Luke's Episcopal Hospital, PO Box 20345, MC 2-114, Houston, Tex 77225-0345, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Natriuretic Factor / blood*
Electrocardiography*
Female
Heart Failure / diagnosis,  mortality*,  surgery
Heart-Assist Devices
Humans
Kinetics
Male
Natriuretic Peptide, Brain
Prognosis
Survival Rate
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor
Comments/Corrections
Comment In:
Circulation. 2003 Apr 8;107(13):e9024-32   [PMID:  12682038 ]
Circulation. 2003 Apr 8;107(13):1719-21   [PMID:  12682028 ]

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