Document Detail


Relation of QRS duration on the surface 12-lead electrocardiogram with mortality in patients with known or suspected coronary artery disease.
MedLine Citation:
PMID:  16214442     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to assess the relation between QRS duration and mortality in patients with known or suspected coronary artery disease, after adjustment for myocardial functional abnormalities, as assessed by exercise echocardiography. We studied 4,033 patients (age 62 +/- 12 years; 2,360 men, 18% with previous myocardial infarction) who underwent symptom-limited exercise echocardiography. The QRS duration was electronically measured from the 12-lead electrocardiogram. The incremental value of the QRS duration for predicting mortality was assessed by adding the QRS duration at the end of each of these modeling steps: clinical data, exercise electrocardiographic, and exercise echocardiographic variables. The QRS duration correlated positively with age, the wall motion score index at rest, and percentage of ischemic segments and negatively with workload (p = 0.0001). Of the 4,033 patients, 252 died during a median follow-up of 3 years. The QRS duration was univariately associated with an increased risk of death (relative risk 8.5, 95% confidence interval CI 4.4 to 16.4, p <0.0001). In an incremental multivariate model, the clinical predictors of mortality were age, male gender, previous infarction, and diabetes mellitus (chi-square 122). Workload was incremental to clinical data in the exercise test model (chi-square 193, p <0.0001). The exercise wall motion score index was incremental to both models (chi-square 211, p <0.001). The QRS duration was associated with an incremental risk of death when added to the clinical model (chi-square 133, p = 0.009), exercise test model (chi-square = 203, p = 0.002), and echocardiographic model (chi-square = 216, p = 0.03). A QRS duration > or =105 ms best identified patients at increased risk. In conclusion, QRS duration is associated with an increased risk of death, even after adjustment for clinical factors, exercise capacity, left ventricular function, and exercise-induced myocardial ischemia.
Authors:
Abdou Elhendy; Stephen C Hammill; Douglas W Mahoney; Patricia A Pellikka
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-08-29
Journal Detail:
Title:  The American journal of cardiology     Volume:  96     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-10     Completed Date:  2005-11-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1082-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Diseases and Internal Medicine, Rochester, Minnesota, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure
Coronary Disease / mortality*,  ultrasonography
Electrocardiography*
Exercise Test
Female
Health Status
Heart Rate
Humans
Male
Middle Aged
Myocardial Ischemia / etiology
Predictive Value of Tests

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


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