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Relationships between QRS duration and left ventricular deformation in hypertrophic cardiomyopathy

Shi Chen1, Mingxuan Duan2, Xi Zhao2

  • 1Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Quantitative Imaging in Medicine and Surgery
|November 10, 2025
PubMed

Insights

Prolonged QRS duration in hypertrophic cardiomyopathy (HCM) correlates with impaired left ventricular (LV) function. This suggests QRS duration can indicate specific deformation patterns in both obstructive and non-obstructive HCM.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrophysiology

Background:

  • QRS duration is a known risk factor for ventricular arrhythmias in hypertrophic cardiomyopathy (HCM).
  • Its association with left ventricular (LV) function and morphology in different HCM subtypes remains unclear.
  • This study investigates QRS duration in relation to LV strain in hypertrophic nonobstructive cardiomyopathy (HNCM) and hypertrophic obstructive cardiomyopathy (HOCM).

Purpose of the Study:

  • To examine the correlation between QRS duration and LV global and segmental strain values.
  • To determine if QRS duration can serve as an indicator of LV dysfunction in HNCM and HOCM patients.
  • To differentiate deformation patterns associated with prolonged QRS duration in HNCM versus HOCM.

Main Methods:

  • Retrospective analysis of 45 HNCM and 81 HOCM patients with preserved ejection fraction.
  • QRS duration measured via standard 12-lead electrocardiograms.
  • LV global and segmental strain assessed using cardiac magnetic resonance feature tracking.

Main Results:

  • QRS duration correlated with global circumferential, radial, and longitudinal strain in HNCM patients.
  • QRS duration correlated with global circumferential and radial strain in HOCM patients.
  • Patients with QRS duration ≥110 ms showed impaired global radial strain and peak systolic/diastolic strain rates in HNCM, and reduced circumferential strain and strain rates in HOCM. Prolonged QRS duration indicated apical deformation in HNCM and mid-wall involvement in HOCM.

Conclusions:

  • QRS duration is associated with global and segmental LV impairments in both HNCM and HOCM.
  • Prolonged QRS duration may indicate specific patterns of LV deformation, such as apical involvement in HNCM and mid-wall changes in HOCM.
  • QRS duration serves as a potential non-invasive marker for assessing LV function and morphology in HCM.
Abstract

Keywords:
QRS durationcardiac magnetic resonance (CMR)hypertrophic cardiomyopathy (HCM)left ventricular deformation (LV deformation)strain

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