ECG low QRS voltage and wide QRS complex predictive of centenarian 360-day mortality
Jan Szewieczek1, Zbigniew Gąsior2, Jan Duława3
1Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland. jszewieczek@sum.edu.pl.
Insights
Electrocardiogram (ECG) findings in centenarians, including specific left ventricular hypertrophy criteria and QRS complex duration, can predict mortality within 360 days. Low QRS voltages and prolonged QRS duration are associated with increased mortality risk in this population.
Area of Science:
- Gerontology
- Cardiology
- Biomedical Engineering
Background:
- Centenarians represent a unique population for studying aging and longevity.
- Understanding the electrocardiographic (ECG) characteristics of centenarians is crucial for assessing their health status and prognosis.
- Previous research has explored ECG findings in older adults, but specific associations with survival in centenarians require further investigation.
Purpose of the Study:
- To investigate the association between electrocardiographic (ECG) findings and 360-day survival in a cohort of centenarians.
- To identify specific ECG parameters that predict mortality in individuals aged 100 years and older.
- To correlate ECG measurements with various clinical and laboratory parameters in centenarians.
Main Methods:
- A cohort of 86 centenarians (mean age 101.9 years) underwent physical, functional, and laboratory assessments, including resting ECG.
- ECG findings were analyzed for left ventricular hypertrophy (LVH) using Romhilt-Estes, Sokolow-Lyon, and Cornell criteria.
- Survival was monitored for at least 360 days, and multivariate logistic regression was used to identify predictors of mortality.
Main Results:
- Fifty-two participants (60%) survived ≥360 days.
- Negative associations with 360-day survival were found for low R wave amplitude in leads II and aVF, low Sokolow-Lyon voltage, prolonged QRS duration (≥90 ms), and Romhilt-Estes LVH score (≥5 points).
- QRS voltage showed correlations with various physiological and biochemical markers, including blood pressure, vitamin B12, inflammatory markers (IL-6, TNF-α), and renal function (eGFR).
Conclusions:
- Specific ECG criteria, including Romhilt-Estes LVH score ≥5, Sokolow-Lyon voltage <1.45 mV, and QRS duration ≥90 ms, are predictive of 360-day mortality in centenarians.
- These ECG findings may serve as valuable non-invasive markers for assessing prognosis in the extremely old.
- Further research can explore the underlying mechanisms linking these ECG abnormalities to mortality in centenarian populations.
Abstract:
We examined the electrocardiographic (ECG) findings of centenarians and associated them with >360-day survival. Physical and functional assessment, resting electrocardiogram and laboratory tests were performed on 86 study participants 101.9 ± 1.2 years old (mean ± SD) (70 women, 16 men) and followed for at least 360 days. Centenarian ECGs were assessed for left ventricular hypertrophy (LVH) according to the Romhilt-Estes score, Sokolow-Lyon criteria and Cornell voltage criteria which were positive for 12.8, 6.98, and 10.5 % of participants, respectively. Fifty-two study participants (60 %) survived ≥360 days. Multivariate logistic regression analysis revealed a negative relationship between 360-day survival and the following: R II <0.45 mV adjusted for CRP (odds ratio (OR) = 0.108, 95 % confidence interval (CI) = 0.034-0.341, P < .001), R aVF < 0.35 mV adjusted for CRP (OR = 0.151, 95 % CI = 0.039-0.584, P < .006), Sokolow-Lyon voltage <1.45 mV adjusted for CRP (OR = 0.178, 95 % CI = 0.064-0.492, P = .001), QRS ≥90 ms adjusted for CRP (OR = 0.375, 95 % CI = 0.144-0.975, P = .044), and Romhilt-Estes score ≥5 points adjusted for sex and Barthel Index (OR = 0.459, 95 % CI = 0.212-0.993, P = .048) in single variable ECG models. QRS voltage correlated positively with systolic and pulse pressure, serum vitamin B12 level, sodium, calcium, phosphorous, TIMP-1, and eGFR. QRS voltage correlated negatively with BMI, WHR, serum leptin, IL-6, TNF-α, and PAI-1 levels. QRS complex duration correlated positively with CRP; QTc correlated positively with TNF-α. Results suggest that Romhilt-Estes LVH criteria scores ≥5 points, low ECG QRS voltages (Sokolow-Lyon voltage <1.45 mV), and QRS complexes ≥90 ms are predictive of centenarian 360-day mortality.
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