PMID- 16198248
OWN - NLM
STAT- MEDLINE
DCOM- 20060228
LR  - 20071115
IS  - 1071-9164 (Print)
IS  - 1071-9164 (Linking)
VI  - 11
IP  - 7
DP  - 2005 Sep
TI  - Prognostic value of the QRS duration in patients with heart failure: a subgroup 
      analysis from 24 centers of Val-HeFT.
PG  - 523-8
AB  - BACKGROUND: This study investigated whether QRS duration (QRS D) is a prognostic 
      indicator in patients with heart failure (New York Heart Association [NYHA] 
      classes II-IV). METHODS AND RESULTS: This subgroup analysis included 248 patients 
      with heart failure recruited in the German centers of the Valsartan Heart Failure 
      Trial (Val-HeFT). Mean age was 60 years, mean NYHA class was 2.3, and mean left 
      ventricular ejection fraction (EF) was 27.9%. Electrocardiograms were recorded 
      and analyzed at the beginning of the study, at 2 weeks, 4 months, 1 year, and 2 
      years. The mean observation period for mortality was 25 months. Patients > or = 
      65 years and patients with an EF <20% had a significantly longer QRS D (P = .02; 
      P = .0005). NYHA class, etiology of heart failure, therapy with 
      angiotensin-converting enzyme inhibitors, amiodarone or beta-blockers, implanted 
      defibrillator, and atrial fibrillation had no significant influence on QRS D. 
      Total mortality was 9%: 14 patients died suddenly, 7 from heart failure, 2 from 
      noncardiac causes. Kaplan-Meier plots show significantly different survival rates 
      for patients with QRS D <120 ms, QRS D 120-159 ms, or QRS D > or = 160 ms (P = 
      .0085). Multivariate analysis showed that QRS D was the only independent risk 
      factor for all-cause mortality (P = .008). NYHA class, EF, atrial fibrillation, 
      age, and gender failed to qualify as independent prognostic factors. CONCLUSION: 
      QRS duration in the surface electrocardiogram is an easily obtainable parameter 
      with a significant prognostic impact in patients with congestive heart failure 
      and a reduced EF. In this German subgroup of Val-HeFT patients, it was an 
      independent predictor of all-cause mortality.
FAU - Hofmann, Monika
AU  - Hofmann M
AD  - Deutsches Herzzentrum Munchen, Technische Universitat Munchen, Munich, Germany.
FAU - Bauer, Ricarda
AU  - Bauer R
FAU - Handrock, Renate
AU  - Handrock R
FAU - Weidinger, Gottfried
AU  - Weidinger G
FAU - Goedel-Meinen, Liselotte
AU  - Goedel-Meinen L
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiomyopathies/diagnosis/physiopathology
MH  - Coronary Disease/diagnosis/physiopathology
MH  - Double-Blind Method
MH  - Electrocardiography/*methods
MH  - Female
MH  - Germany
MH  - Heart Conduction System/physiopathology
MH  - Heart Failure/*diagnosis/mortality/*physiopathology
MH  - Humans
MH  - Hypertension/diagnosis/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prognosis
MH  - Reproducibility of Results
MH  - Risk Factors
MH  - Stroke Volume/physiology
MH  - Survival Analysis
EDAT- 2005/10/04 09:00
MHDA- 2006/03/01 09:00
CRDT- 2005/10/04 09:00
PHST- 2004/06/08 00:00 [received]
PHST- 2005/02/10 00:00 [revised]
PHST- 2005/03/16 00:00 [accepted]
PHST- 2005/10/04 09:00 [pubmed]
PHST- 2006/03/01 09:00 [medline]
PHST- 2005/10/04 09:00 [entrez]
AID - S1071-9164(05)00135-1 [pii]
AID - 10.1016/j.cardfail.2005.03.008 [doi]
PST - ppublish
SO  - J Card Fail. 2005 Sep;11(7):523-8. doi: 10.1016/j.cardfail.2005.03.008.