Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study.

Mentz, Robert J

Greiner, Melissa A

DeVore, Adam D

Dunlay, Shannon M

Choudhary, Gaurav

Ahmad, Tariq

Khazanie, Prateeti

Randolph, Tiffany C

Griswold, Michael E

Eapen, Zubin J

O'Brien, Emily C

Thomas, Kevin L

Curtis, Lesley H

Hernandez, Adrian F

United States

2015-12-03T21:36:39Z

2015-03

BACKGROUND: QRS prolongation is associated with adverse outcomes in mostly white populations, but its clinical significance is not well established for other groups. We investigated the association between QRS duration and mortality in African Americans. METHODS AND RESULTS: We analyzed data from 5146 African Americans in the Jackson Heart Study stratified by QRS duration on baseline 12-lead ECG. We defined QRS prolongation as QRS≥100 ms. We assessed the association between QRS duration and all-cause mortality using Cox proportional hazards models and reported the cumulative incidence of heart failure hospitalization. We identified factors associated with the development of QRS prolongation in patients with normal baseline QRS. At baseline, 30% (n=1528) of participants had QRS prolongation. The cumulative incidences of mortality and heart failure hospitalization were greater with versus without baseline QRS prolongation: 12.6% (95% confidence interval [CI], 11.0-14.4) versus 7.1% (95% CI, 6.3-8.0) and 8.2% (95% CI, 6.9-9.7) versus 4.4% (95% CI, 3.7-5.1), respectively. After risk adjustment, QRS prolongation was associated with increased mortality (hazard ratio, 1.27; 95% CI, 1.03-1.56; P=0.02). There was a linear relationship between QRS duration and mortality (hazard ratio per 10 ms increase, 1.06; 95% CI, 1.01-1.12). Older age, male sex, prior myocardial infarction, lower ejection fraction, left ventricular hypertrophy, and left ventricular dilatation were associated with the development of QRS prolongation. CONCLUSIONS: QRS prolongation in African Americans was associated with increased mortality and heart failure hospitalization. Factors associated with developing QRS prolongation included age, male sex, prior myocardial infarction, and left ventricular structural abnormalities.

http://www.ncbi.nlm.nih.gov/pubmed/25550439

CIRCHEARTFAILURE.114.001729

1941-3297

https://hdl.handle.net/10161/11076

eng

Ovid Technologies (Wolters Kluwer Health)

Circ Heart Fail

10.1161/CIRCHEARTFAILURE.114.001729

African American

heart failure

mortality

ventricular conduction

Adult

African Americans

Female

Heart Conduction System

Heart Failure

Humans

Hypertrophy, Left Ventricular

Male

Middle Aged

Observational Studies as Topic

Proportional Hazards Models

Risk Factors

Stroke Volume

Treatment Outcome

Ventricular Dysfunction, Left

Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study.

Journal article

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

DeVore, Adam D|0000-0002-4679-2221

O'Brien, Emily C|0000-0002-8257-7561

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

Curtis, Lesley H|0000-0002-3286-9371

Hernandez, Adrian F|0000-0003-3387-9616

http://www.ncbi.nlm.nih.gov/pubmed/25550439

243

251

2

Clinical Science Departments

Duke

Duke Clinical Research Institute

Institutes and Centers

Medicine

Medicine, Cardiology

Medicine, Clinical Pharmacology

Medicine, General Internal Medicine

School of Medicine

Published

8