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Ethnic differences in the association of QRS duration with ejection fraction and outcome in heart failure

Gijsberts, Crystel M. (författare)
ICIN Netherlands Heart Institute, Netherlands; University of Medical Centre Utrecht, Netherlands
Benson, Lina (författare)
Karolinska Institute, Sweden
Dahlström, Ulf (författare)
Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US
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Sim, David (författare)
Singhealth, Singapore
Yeo, Daniel P. S. (författare)
Tan Tock Seng Hospital, Singapore
Yee Ong, Hean (författare)
Khoo Teck Puat Hospital, Singapore
Jaufeerally, Fazlur (författare)
Singapore Gen Hospital, Singapore; Duke NUS, Singapore
Leong, Gerard K. T. (författare)
Changi Gen Hospital, Singapore
Ling, Lieng H. (författare)
National University of Singapore, Singapore; National University of Health Syst, Singapore
Mark Richards, A. (författare)
National University of Singapore, Singapore; National University of Health Syst, Singapore; National University of Singapore, Singapore; University of Otago, New Zealand
de Kleijn, Dominique P. V. (författare)
ICIN Netherlands Heart Institute, Netherlands; University of Medical Centre Utrecht, Netherlands; National University of Singapore, Singapore; National University of Singapore, Singapore
Lund, Lars H. (författare)
Karolinska Institute, Sweden; Karolinska Institute, Sweden
Lam, Carolyn S. P. (författare)
Singhealth, Singapore; National University of Singapore, Singapore; National University of Singapore, Singapore
Gijsberts, CM (författare)
Sim, D (författare)
Ling, LH (författare)
de Kleijn, DPV (författare)
Ong, HY (författare)
Yeo, DPS (författare)
Leong, GKT (författare)
Richards, AM (författare)
Lam, CSP (författare)
Jaufeerally, F (författare)
Lund, LH (författare)
Karolinska Institutet
Dahlstrom, U (författare)
Benson, L (författare)
Karolinska Institutet
visa färre...
 (creator_code:org_t)
BMJ PUBLISHING GROUP, 2016
2016
Engelska.
Ingår i: Heart. - : BMJ PUBLISHING GROUP. - 1355-6037 .- 1468-201X. ; 102:18, s. 1464-1471
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background QRS duration (QRSd) criteria for device therapy in heart failure (HF) were derived from predominantly white populations and ethnic differences are poorly understood. Methods We compared the association of QRSd with ejection fraction (EF) and outcomes between 839 Singaporean Asian and 11221 Swedish white patients with HF having preserved EF (HFPEF)and HF having reduced EF (HFREF) were followed in prospective population-based HF studies. Results Compared with whites, Asian patients with HF were younger (62 vs 74years, pamp;lt;0.001), had smaller body size (height 163 vs 171cm, weight 70 vs 80kg, both pamp;lt;0.001) and had more severely impaired EF (EF was amp;lt;30% in 47% of Asians vs 28% of whites). Overall, unadjusted QRSd was shorter in Asians than whites (101 vs 104ms, pamp;lt;0.001). Lower EF was associated with longer QRSd (pamp;lt;0.001), with a steeper association among Asians than whites (p(interaction)amp;lt;0.001), independent of age, sex and clinical covariates (including body size). Excluding patients with left bundle branch block (LBBB) and adjusting for clinical covariates, QRSd was similar in Asians and whites with HFPEF, but longer in Asians compared with whites with HFREF (p=0.001). Longer QRSd was associated with increased risk of HF hospitalisation or death (absolute 2-year event rate for 120ms was 40% and for amp;gt;120ms it was 52%; HR for 10ms increase of QRSd was 1.04 (1.03 to 1.06), pamp;lt;0.001), with no interaction by ethnicity. Conclusion We found ethnic differences in the association between EF and QRSd among patients with HF. QRS prolongation was similarly associated with increased risk, but the implications for ethnicity-specific QRSd cut-offs in clinical decision-making require further study.

Ämnesord

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

ECG; electrocardiogram

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