Prognostic Implication of QRS Variability during Hospitalization in Patients with Acute Decompensated Heart Failure
Korean Circulation Journal 2014³â 44±Ç 1È£ p.22 ~ p.29
À̼ҷÉ(Lee So-Ryoung) - Seoul National University Hospital Department of Internal Medicine
ÃÖÀDZÙ(Choi Eue-Keun) - Seoul National University College of Medicine Department of Internal Medicine
°µµÀ±(Kang Do-Yoon) - Seoul National University Hospital Department of Internal Medicine
Â÷¸íÁø(Cha Myung-Jin) - Seoul National University Hospital Department of Internal Medicine
Á¶¿µÁø(Cho Young-Jin) - Seoul National University Hospital Department of Internal Medicine
¿À¼¼ÀÏ(Oh Se-Il) - Seoul National University College of Medicine Department of Internal Medicine
¿ÀÀÏ¿µ(Oh Il-Young) - Seoul National University Bundang Hospital Regional Cardiocerebrovascular Center
Abstract
Background and Objectives: Heart failure (HF) patients display more varied QRS duration. We investigated whether QRS variability during hospitalization for acute decompensated HF is associated with poor clinical outcomes after discharge.
Subjects and Methods: One hundred seventy three patients (64% males; age 60¡¾13 years) admitted for acute decompensated HF with severe left ventricular (LV) dysfunction (LV ejection fraction ¡Â35%) were consecutively enrolled. QRS variability was calculated by the difference between maximum and minimum QRS duration acquired during hospitalization. The prognostic implications on composite endpoints of death or urgent heart transplantation were analyzed.
Results: Forty-two patients (24.3%) died and three patients (1.7%) underwent urgent heart transplantation during the follow-up of 51¡¾18 months. Patients who reached composite endpoints (n=45) showed greater QRS variability than those who did not (n=128) (20¡¾23 ms vs. 14¡¾14 ms, p=0.046). Patients who had high QRS variability (more than 22 ms; n=36) tended to have a higher event rate than those with QRS variability <22 ms {39% vs. 23%, hazard ratio (HR), 1.88; 95% confidence interval (CI) 1.001-3.539, p=0.05}. Adjusting with other variables, high QRS variability was an independent predictor for composite outcome (HR 1.94; 95% CI 1.023-3.683, p=0.042).
Conclusion: QRS variability measured during hospitalization for acute decompensated HF has a prognostic impact in HF patients with severe LV dysfunction.
Å°¿öµå
Heart failure, Heart decompensation, Electrocardiography, variation, Prognosis
KMID :
0368120140440010022
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
À¯È¿¼º°á°ú(Recomendation)