Ethnic differences in the association of QRS duration with ejection fraction and outcome in heart failure.
Heart
; 102(18): 1464-71, 2016 09 15.
Article
em En
| MEDLINE
| ID: mdl-27402805
ABSTRACT
BACKGROUND:
QRS duration (QRSd) criteria for device therapy in heart failure (HF) were derived from predominantly white populations and ethnic differences are poorly understood.METHODS:
We compared the association of QRSd with ejection fraction (EF) and outcomes between 839 Singaporean Asian and 11â 221 Swedish white patients with HF having preserved EF (HFPEF)and HF having reduced EF (HFREF) were followed in prospective population-based HF studies.RESULTS:
Compared with whites, Asian patients with HF were younger (62 vs 74â years, p<0.001), had smaller body size (height 163 vs 171â cm, weight 70 vs 80â kg, both p<0.001) and had more severely impaired EF (EF was <30% in 47% of Asians vs 28% of whites). Overall, unadjusted QRSd was shorter in Asians than whites (101 vs 104â ms, p<0.001). Lower EF was associated with longer QRSd (p<0.001), with a steeper association among Asians than whites (pinteraction<0.001), independent of age, sex and clinical covariates (including body size). Excluding patients with left bundle branch block (LBBB) and adjusting for clinical covariates, QRSd was similar in Asians and whites with HFPEF, but longer in Asians compared with whites with HFREF (p=0.001). Longer QRSd was associated with increased risk of HF hospitalisation or death (absolute 2-year event rate for ≤120â ms was 40% and for >120â ms it was 52%; HR for 10â ms increase of QRSd was 1.04 (1.03 to 1.06), p<0.001), with no interaction by ethnicity.CONCLUSION:
We found ethnic differences in the association between EF and QRSd among patients with HF. QRS prolongation was similarly associated with increased risk, but the implications for ethnicity-specific QRSd cut-offs in clinical decision-making require further study.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Volume Sistólico
/
Povo Asiático
/
População Branca
/
Disparidades nos Níveis de Saúde
/
Sistema de Condução Cardíaco
/
Insuficiência Cardíaca
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
/
Europa
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article