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Relation of QRS duration to mortality in a community-based cohort with hypertrophic cardiomyopathy

Sergio Bongioanni1, Francesca Bianchi, Alessandro Migliardi

  • 1Ospedale degli Infermi, Rivoli, Torino, Italy. sergio.bongioanni@virgilio.it

The American Journal of Cardiology
|July 31, 2007
PubMed

Insights

A prolonged QRS duration, a measure on electrocardiograms, significantly increases cardiovascular death risk in hypertrophic cardiomyopathy (HC) patients. A QRS duration of 120 ms or more is a strong, independent predictor of poor prognosis in HC.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Medicine

Background:

  • Prolonged QRS duration is linked to cardiovascular mortality in various cardiomyopathies.
  • The prognostic significance of QRS duration in hypertrophic cardiomyopathy (HC) is not well-defined.

Purpose of the Study:

  • To assess the relationship between QRS duration and cardiovascular death in patients with HC.
  • To determine if QRS duration is an independent predictor of prognosis in HC.

Main Methods:

  • A cohort of 241 consecutive HC patients was analyzed.
  • Patients were grouped based on QRS duration (<120 ms vs. ≥120 ms).
  • Cardiovascular death events were tracked over a mean follow-up of 7.9 years, with multivariate analysis performed.

Main Results:

  • A QRS duration of ≥120 ms was observed in 21% of patients.
  • Patients with QRS duration ≥120 ms had a significantly higher risk of cardiovascular death (relative risk 5.2, p <0.0001).
  • At 8 years, cumulative HC-related death risk was 7.1% for QRS <120 ms and 55% for QRS ≥120 ms. QRS duration ≥120 ms was independently associated with increased cardiovascular death risk (hazard ratio 3.2, p = 0.007).

Conclusions:

  • QRS duration on standard electrocardiogram is directly related to cardiovascular mortality in HC patients.
  • A QRS duration of ≥120 ms is a strong and independent predictor of prognosis in HC.
  • NYHA functional class III/IV was the only other clinical variable independently associated with increased cardiovascular death risk.

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