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Prolonged QTc interval and high B-type natriuretic peptide levels together predict mortality in patients with

Bojan Vrtovec1, Reynolds Delgado, Aly Zewail

  • 1Heart Failure Center, Texas Heart Institute at St Luke's Episcopal Hospital, PO Box 20345, MC 2-114, Houston, Tex 77225-0345, USA.

Circulation
|April 1, 2003
PubMed

Insights

Prolonged QTc interval is a strong predictor of adverse outcomes in heart failure patients with high B-type natriuretic peptide (BNP) levels. This finding highlights QTc prolongation as a key indicator for increased mortality risk.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • The prognostic significance of QTc interval prolongation in heart failure (HF) is not well-established.
  • High B-type natriuretic peptide (BNP) levels indicate significant cardiac strain in HF patients.

Purpose of the Study:

  • To investigate the relationship between QTc interval duration and outcomes in HF patients with elevated BNP.
  • To determine if QTc prolongation independently predicts mortality in this patient cohort.

Main Methods:

  • QTc intervals were measured using 12-lead ECG and corrected with Bazett's formula in 241 HF patients with BNP >400 pg/mL.
  • Patients were categorized into prolonged QTc (>440 ms) and normal QTc groups.
  • Outcomes including death, transplantation, and left ventricular assist device (LVAD) implantation were tracked over 6 months.

Main Results:

  • 51% of patients had a prolonged QTc interval; BNP levels did not differ significantly between groups.
  • The prolonged QTc group experienced a 3-fold higher mortality rate compared to the normal QTc group (P<0.0001).
  • Multivariate analysis confirmed prolonged QTc as an independent predictor of all-cause death, cardiac death, sudden cardiac death, and pump failure death.

Conclusions:

  • Prolonged QTc interval is a significant independent predictor of adverse outcomes in heart failure patients with elevated BNP.
  • QTc prolongation serves as a critical prognostic marker in this high-risk population.
Abstract

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