QT interval and short-term outcome in acute heart failure
Òscar Miró1,2, Oriol Aguiló3, Joan Carles Trullàs4
1Emergency Department, Hospital Clínic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain. omiro@clinic.cat.
Summary
In acute heart failure (AHF) patients, corrected QT (QTc) interval duration offers prognostic insight. Longer QTc correlates with increased mortality, while both shortened and prolonged QTc predict hospitalization needs.
Area of Science:
- Cardiology
- Clinical Medicine
- Electrocardiography
Background:
- Acute heart failure (AHF) is a leading cause of hospitalization and mortality.
- The corrected QT (QTc) interval, reflecting ventricular repolarization, is a known marker for cardiac risk.
- Understanding the prognostic value of QTc in AHF patients is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the association between corrected QT (QTc) interval duration and short-term clinical outcomes in patients presenting with acute heart failure (AHF).
- To determine if QTc interval length can serve as an independent predictor of mortality and hospitalization in the emergency department (ED) setting.
Main Methods:
- Analysis of 1800 AHF patients from 11 Spanish EDs with available ECG and QTc measurements.
- Exclusion of patients with pacemaker rhythm.
- Primary outcome: 30-day all-cause mortality. Secondary outcomes: hospitalization, in-hospital mortality, and prolonged hospitalization (>7 days).
- Utilized restricted cubic spline (RCS) curves to explore the association between QTc and outcomes, adjusting for baseline and decompensation characteristics.
Main Results:
- A longer QTc interval was significantly associated with increased 30-day mortality (e.g., OR 10.5 for QTc=674 ms) and in-hospital mortality (e.g., OR 8.02 for QTc=674 ms).
- A U-shaped relationship was observed for the need of hospitalization, with both shortened (e.g., OR 5.88 for QTc=200 ms) and prolonged QTc intervals (e.g., OR 2.15 for QTc=588 ms) associated with higher likelihood of admission.
- No significant association was found between QTc interval and prolonged hospitalization (>7 days).
Conclusions:
- Initial QTc interval measurement in the ED provides independent prognostic information for AHF patients.
- An increasing QTc interval duration is linked to a higher risk of mortality.
- Both shortened and prolonged QTc intervals are associated with an increased need for hospitalization in AHF patients.
More Related Videos
08:19Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs
Published on: July 12, 2022
2.9K
05:15Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
153
Related Concept Videos
01:22Heart Failure VI: Adjunct Therapies
20
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
20
01:30Acute Coronary Syndrome III: Diagnostic Studies
16
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
16
01:30Heart Failure IV: Classification and Diagnostic Evaluation
23
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
23
01:26Heart Failure III: Clinical Manifestations
29
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
29
01:30Heart Failure V: Medical Management
18
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
18
01:28Acute Coronary Syndrome IV: Interprofessional Care
17
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
17