Korean Circulation Journal

  • 제44권1호
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  • Pages.22-29
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  • 2014
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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DOI QR코드

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Prognostic Implication of QRS Variability during Hospitalization in Patients with Acute Decompensated Heart Failure

  • Lee, So-Ryoung (Department of Internal Medicine, Seoul National University Hospital) ;
  • Choi, Eue-Keun (Department of Internal Medicine, Seoul National University Hospital) ;
  • Kang, Do-Yoon (Department of Internal Medicine, Seoul National University Hospital) ;
  • Cha, Myung-Jin (Department of Internal Medicine, Seoul National University Hospital) ;
  • Cho, Youngjin (Department of Internal Medicine, Seoul National University Hospital) ;
  • Oh, Il-Young (Cardiovascular Center, Seoul National University Bundang Hospital) ;
  • Oh, Seil (Department of Internal Medicine, Seoul National University Hospital)
  • 투고 : 2013.07.10
  • 심사 : 2013.11.18
  • 발행 : 2014.01.30
⟨ 이전 논문 다음 논문 ⟩

초록

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 $60{\pm}13$ years) admitted for acute decompensated HF with severe left ventricular (LV) dysfunction (LV ejection fraction ${\leq}35%$) 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 $51{\pm}18$ months. Patients who reached composite endpoints (n=45) showed greater QRS variability than those who did not (n=128) ($20{\pm}23ms$ vs. $14{\pm}14ms$, 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.

키워드

과제정보

연구 과제 주관 기관 : Seoul National University Hospital

참고문헌

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