Mi. Anastasiou-nana et al., Relation of dispersion of QRS and QT in patients with advanced congestive heart failure to cardiac and sudden death mortality, AM J CARD, 85(10), 2000, pp. 1212-1217
Citations number
14
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
This study examined the usefulness of QT and QRS dispersion in the prognosi
s of patients with advanced congestive heart failure (CHF). One hundred fou
r patients in New York Heart Association functional classes II to IV, with
a left ventricular election fraction of <35%, and untreated with antiarrhyt
hmic drugs, were followed prospectively. QRS and QT dispersion were defined
as the maximum difference in QRS and QT interval duration, respectively, m
easured on all leads of standard 12-lead electrocardiograms. The end points
of the study were nonsudden and sudden cardiac mortality. During an averag
e follow-up of 20 months, there were 13 nonsudden and 10 sudden deaths. The
average QRS duration was significantly longer in nonsurvivors than in surv
ivors (125 +/- 34 vs 113 +/- 34 ms, respectively, p <0.04). Similar results
were obtained with QT dispersion (95 +/- 48 ms vs 78 +/- 31 ms, respective
ly, p <0.03) and QRS dispersion (54 +/- 17 ms vs 46 +/- 16 ms, respectively
, p <0.02). Furthermore, patients who died suddenly had significantly great
er QRS dispersion than patients who survived (56 +/- 13 vs 46 +/- 16 ms, re
spectively, p <0.02). In a multivaricrte analysis, QT and QRS dispersion we
re both independent predictors of nonsudden cardiac death (p = 0.01 and p =
0.001, respectively), and QRS dispersion was also an independent predictor
of sudden cardiac death (p = 0.04). Death rate in patients with QT dispers
ion >90 ms was 2.8-fold higher than those with QT dispersion less than or e
qual to 90 ms (95% confidence intervals [CI] 1.2 to 6.4). Similarly, the de
ath rate in patients with QRS dispersion >46 ms was 3.9-fold higher than in
those with QRS dispersion less than or equal to 46 ms (95% CI 1.6 to 9.5).
These findings suggest that QT and QRS dispersion are useful predictors of
mortality in patients with advanced CHF. (C) 2000 by Excerpta Medica, Inc.