PMID- 25903113
OWN - NLM
STAT- MEDLINE
DCOM- 20160809
LR  - 20220410
IS  - 1861-0692 (Electronic)
IS  - 1861-0684 (Linking)
VI  - 104
IP  - 11
DP  - 2015 Nov
TI  - The relationship of QRS morphology with cardiac structure and function in 
      patients with heart failure.
PG  - 935-45
LID - 10.1007/s00392-015-0861-0 [doi]
AB  - INTRODUCTION: The relationship of QRS morphology with cardiac structure and 
      function in patients with heart failure is uncertain. METHODS: Patients with a 
      clinical diagnosis of heart failure and objective evidence of cardiac dysfunction 
      [either a left ventricular ejection fraction (LVEF) <50 % or an amino-terminal 
      pro-brain natriuretic peptide (NT-proBNP) >/=400 pg/ml] who had been investigated 
      by cardiac magnetic resonance imaging (CMRI) were identified. QRS duration 
      >/=120 ms was grouped morphologically as left (LBBB), right bundle branch block 
      (RBBB) or indeterminate. RESULTS: Of 877 patients, 320 (36 %) had QRS >/= 120 ms. 
      Compared to patients with LBBB, those with RBBB had a lower median 
      [inter-quartile range (IQR)] right ventricular (RV) ejection fraction [RBBB: 46 
      (37-57); LBBB: 52 (42-61) %; p = 0.014], greater median (IQR) RV mass [RBBB: 53 
      (42-73); LBBB: 45 (36-56) g; p < 0.001], higher median (IQR) plasma NT-proBNP 
      [RBBB: 2013 (659-3573); LBBB: 1159 (589-2207) pg/ml, p = 0.026], more signs of 
      peripheral congestion and higher prevalence of atrial fibrillation but had 
      similar LVEF. During a median follow-up of 1302 days (IQR: 742-2237), 311 
      patients died. Compared with patients who had QRS < 120 ms, those with RBBB [HR 
      1.98, 95 % CI (1.37-2.86); p < 0.001] had a higher mortality. Age and NT-proBNP 
      were the strongest independent predictors of mortality; neither QRS nor CMRI 
      variables improved prediction. CONCLUSIONS: In patients with heart failure and 
      QRS >/= 120 ms, RBBB is associated with more severe RV dysfunction and congestion 
      and a worse prognosis. However, neither QRS morphology nor CMRI data provide 
      independent prognostic information in a multivariable analysis including 
      NT-proBNP.
FAU - Pellicori, Pierpaolo
AU  - Pellicori P
AD  - Department of Cardiology, Hull York Medical School, Hull and East Yorkshire 
      Medical Research and Teaching Centre, Castle Hill Hospital, University of Hull, 
      Cottingham, Kingston upon Hull, HU16 5JQ, UK. p.pel@libero.it.
FAU - Joseph, Anil C
AU  - Joseph AC
AD  - Department of Cardiology, Hull York Medical School, Hull and East Yorkshire 
      Medical Research and Teaching Centre, Castle Hill Hospital, University of Hull, 
      Cottingham, Kingston upon Hull, HU16 5JQ, UK.
FAU - Zhang, Jufen
AU  - Zhang J
AD  - Department of Cardiology, Hull York Medical School, Hull and East Yorkshire 
      Medical Research and Teaching Centre, Castle Hill Hospital, University of Hull, 
      Cottingham, Kingston upon Hull, HU16 5JQ, UK.
FAU - Lukaschuk, Elena
AU  - Lukaschuk E
AD  - Department of Cardiology, Hull York Medical School, Hull and East Yorkshire 
      Medical Research and Teaching Centre, Castle Hill Hospital, University of Hull, 
      Cottingham, Kingston upon Hull, HU16 5JQ, UK.
FAU - Sherwi, Nasser
AU  - Sherwi N
AD  - Department of Cardiology, Hull York Medical School, Hull and East Yorkshire 
      Medical Research and Teaching Centre, Castle Hill Hospital, University of Hull, 
      Cottingham, Kingston upon Hull, HU16 5JQ, UK.
FAU - Bourantas, Christos V
AU  - Bourantas CV
AD  - Department of Cardiology, Hull York Medical School, Hull and East Yorkshire 
      Medical Research and Teaching Centre, Castle Hill Hospital, University of Hull, 
      Cottingham, Kingston upon Hull, HU16 5JQ, UK.
FAU - Loh, Huan
AU  - Loh H
AD  - Department of Cardiology, Hull York Medical School, Hull and East Yorkshire 
      Medical Research and Teaching Centre, Castle Hill Hospital, University of Hull, 
      Cottingham, Kingston upon Hull, HU16 5JQ, UK.
FAU - Clark, Andrew L
AU  - Clark AL
AD  - Department of Cardiology, Hull York Medical School, Hull and East Yorkshire 
      Medical Research and Teaching Centre, Castle Hill Hospital, University of Hull, 
      Cottingham, Kingston upon Hull, HU16 5JQ, UK.
FAU - Cleland, John Gf
AU  - Cleland JG
AD  - Department of Cardiology, Hull York Medical School, Hull and East Yorkshire 
      Medical Research and Teaching Centre, Castle Hill Hospital, University of Hull, 
      Cottingham, Kingston upon Hull, HU16 5JQ, UK.
LA  - eng
PT  - Journal Article
DEP - 20150423
PL  - Germany
TA  - Clin Res Cardiol
JT  - Clinical research in cardiology : official journal of the German Cardiac Society
JID - 101264123
SB  - IM
MH  - Aged
MH  - Bundle-Branch Block/diagnosis/*mortality/pathology/physiopathology
MH  - Causality
MH  - Comorbidity
MH  - Electrocardiography/*statistics & numerical data
MH  - Female
MH  - Heart Failure/*mortality/*pathology/physiopathology
MH  - Heart Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Reproducibility of Results
MH  - Risk Factors
MH  - Sensitivity and Specificity
MH  - Structure-Activity Relationship
MH  - Survival Rate
MH  - United Kingdom/epidemiology
MH  - Ventricular Dysfunction, Right/*mortality/*pathology/physiopathology
OTO - NOTNLM
OT  - Magnetic resonance imaging
OT  - Prognosis
OT  - QRS morphology
OT  - Right ventricular function
EDAT- 2015/04/24 06:00
MHDA- 2016/08/10 06:00
CRDT- 2015/04/24 06:00
PHST- 2014/12/11 00:00 [received]
PHST- 2015/04/15 00:00 [accepted]
PHST- 2015/04/24 06:00 [entrez]
PHST- 2015/04/24 06:00 [pubmed]
PHST- 2016/08/10 06:00 [medline]
AID - 10.1007/s00392-015-0861-0 [pii]
AID - 10.1007/s00392-015-0861-0 [doi]
PST - ppublish
SO  - Clin Res Cardiol. 2015 Nov;104(11):935-45. doi: 10.1007/s00392-015-0861-0. Epub 
      2015 Apr 23.