Race and Sex Differences in QRS Interval and Associated Outcome Among Patients with Left Ventricular Systolic Dysfunction.

Randolph, Tiffany C

Broderick, Samuel

Shaw, Linda K

Chiswell, Karen

Mentz, Robert J

Kutyifa, Valentina

Velazquez, Eric J

Gilliam, Francis R

Thomas, Kevin L

England

2017-10-02T20:03:46Z

2017-10-02T20:03:46Z

2017-03-20

BACKGROUND: Prolonged QRS duration is associated with increased mortality among heart failure patients, but race or sex differences in QRS duration and associated effect on outcomes are unknown. METHODS AND RESULTS: We investigated QRS duration and morphology among 2463 black and white patients with heart failure and left ventricular ejection fraction ≤35% who underwent coronary angiography and 12-lead electrocardiography at Duke University Hospital from 1995 through 2011. We used multivariable Cox regression models to assess the relationship between QRS duration and all-cause mortality and investigate race-QRS and sex-QRS duration interaction. Median QRS duration was 105 ms (interquartile range [IQR], 92-132) with variation by race and sex (P<0.001). QRS duration was longest in white men (111 ms; IQR, 98-139) followed by white women (108 ms; IQR, 92-140), black men (100 ms; IQR, 91-120), and black women (94 ms; IQR, 86-118). Left bundle branch block was more common in women than men (24% vs 14%) and in white (21%) versus black individuals (12%). In black patients, there was a 16% increase in risk of mortality for every 10 ms increase in QRS duration up to 112 ms (hazard ratio, 1.16; 95% CI, 1.07, 1.25) that was not present among white patients (interaction, P=0.06). CONCLUSIONS: Black individuals with heart failure had a shorter QRS duration and more often had non-left bundle branch block morphology than white patients. Women had left bundle branch block more commonly than men. Among black patients, modest QRS prolongation was associated with increased mortality.

https://www.ncbi.nlm.nih.gov/pubmed/28320746

JAHA.116.004381

2047-9980

https://hdl.handle.net/10161/15612

eng

Ovid Technologies (Wolters Kluwer Health)

J Am Heart Assoc

10.1161/JAHA.116.004381

QRS

heart failure

mortality

race

sex

Race and Sex Differences in QRS Interval and Associated Outcome Among Patients with Left Ventricular Systolic Dysfunction.

Journal article

Chiswell, Karen|0000-0002-0279-9093

Mentz, Robert J|0000-0002-3222-1719

Velazquez, Eric J|0000-0003-2245-7477

Thomas, Kevin L|0000-0002-0040-5396

https://www.ncbi.nlm.nih.gov/pubmed/28320746

3

Clinical Science Departments

Duke

Duke Clinical Research Institute

Institutes and Centers

Medicine

Medicine, Cardiology

School of Medicine

Staff

Published online

6