RESUMEN
Objective:To investigate the relationship between the changes of electrocardiogram QRS duration features and the occurrence of adverse cardiac events in patients with heart failure.Methods:The clinical data of 298 patients with heart failure who received treatment in Lishui City People's Hospital from June 2021 to June 2022 were retrospectively analyzed. According to the type of heart failure, they were divided into the diastolic heart failure group ( n = 158) and the systolic heart failure group ( n= 140). According to whether having cardiac events, they were divided into a cardiac event group ( n = 97) and a non-cardiac event group ( n = 201) group. An additional 120 patients who concurrently received health examinations were included in the control group. QRS wave duration and cardiac function indicators were analyzed. QRS wave duration and cardiac function indicators were compared between heart failure and control groups. Changes in QRS wave duration and cardiac function indicators were compared between diastolic heart failure and systolic heart failure groups. Changes in QRS wave duration and cardiac function indicators were compared between cardiac event and non-cardiac event groups. The value of the receiver operating characteristic curve in predicting adverse cardiac events was analyzed. Pearson correlation analysis was performed to analyze the correlation between QRS wave duration and cardiac function. Results:QRS wave duration in the heart failure group was (125.42 ± 14.35) ms, which was significantly longer than (78.82 ± 6.49) ms in the control group ( t = 34.17, P < 0.001). Left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) in the heart failure group were (156.24 ± 21.42) mL and (78.28 ± 9.43) mL, respectively, which were significantly higher than (107.48 ± 19.23) mL and (45.62 ± 5.42) mL, respectively in the control group ( t = 21.66, 35.63, both P < 0.01). Left ventricular ejection fraction (LVEF) in the heart failure group was (46.98 ± 4.25)%, which was significantly lower than (67.94 ± 5.46)% in the control group ( t = 41.88, P < 0.001). QRS wave duration in the systolic heart failure group was (140.21 ± 18.57) ms, which was significantly longer than (112.31 ± 13.42) ms in the diastolic heart failure group ( t = 16.29, P < 0.001). LVESV and LVEDV in the systolic heart failure group were (183.36 ± 27.67) mL and (95.39 ± 12.13) mL, respectively, which were significantly higher than (132.21 ± 18.98) mL and (63.12 ± 7.84) mL in the diastolic heart failure group ( t = 20.30, 29.61, both P < 0.001). LVEF in the systolic heart failure group was (38.19 ± 4.61)%, which was significantly lower than (54.77 ± 4.92)% in the diastolic heart failure group ( t = 34.18, P < 0.001). QRS wave duration in the cardiac event group was (169.37 ± 17.43) ms, which was significantly longer than (104.21 ± 12.49) ms in the non-cardiac event group ( t = 36.91, P < 0.001). LVESV and LVEDV in the cardiac event group were (199.30 ± 23.41) mL and (105.22 ± 15.64) mL, respectively which were significantly higher than (135.46 ± 15.46) mL and (65.28 ± 6.92) mL in the non-cardiac event group ( t = 28.04, 30.57, both P < 0.001). LVEF in the cardiac event group was (32.97 ± 5.16)%, which was significantly lower than (53.74 ± 4.52)% in the non-cardiac event group ( t = 35.46, P < 0.001). The receiver operating characteristic curve analysis showed that the sensitivity and specificity of QRS wave duration in predicting adverse cardiac events were 88.7% and 86.6%, respectively. Pearson analysis showed that QRS wave duration, LVESV, and LVEDV were positively correlated with the occurrence of adverse cardiac events ( r = 0.684, 0.546, 0.518, all P < 0.05), while LVEF was negatively correlated with the occurrence of adverse cardiac events ( r = -0.627, P < 0.05). Conclusion:QRS wave duration in patients with heart failure is significantly prolonged, and it is obviously related to the occurrence of adverse cardiac events.