Int J Heart Fail.  2020 Apr;2(2):121-130. 10.36628/ijhf.2019.0016.

Prognostic Value of QRS Duration among Patients with Cardiogenic Shock Complicating Acute Heart Failure: Data from the Korean Acute Heart Failure (KorAHF) Registry

Affiliations
  • 1Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
  • 3Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul, Korea
  • 4Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
  • 5Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea
  • 6Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
  • 7Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 8Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 9Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 10Heart Research Center of Chonnam National University, Gwangju, Korea
  • 11Division of Cardiology, Cardiovascular Center, Mediplex Sejong Hospital, Incheon, Korea

Abstract

Background and Objectives
Prolonged QRS duration is associated with poor outcomes in patients with chronic heart failure (HF). However, the prognostic value of QRS duration in patients with cardiogenic shock complicating acute HF remains unknown. We evaluated the hypothesis that prolonged QRS duration may be associated with short-term mortality among acute HF patients with cardiogenic shock (CS).
Methods
From March 2011 through December 2013, a total of 5,625 acute HF patients were consecutively enrolled in ten tertiary university hospitals. Among them, we analyzed patients who presented with CS. Patients were divided into three groups by QRS duration cutoff values of 130 and 150 ms. The primary endpoint was 30-day in-hospital mortality.
Results
Two hundred eleven patients presented with CS at admission and those with available electrocardiograms were included in this analysis. There were 35 patients with QRS durations of 150 ms or above, 30 patients with QRS durations between 130 ms and 150 ms, and 146 patients with QRS durations below 130 ms. The 30-day all cause in-hospital mortality rates were 43.7%, 33.1%, and 24.9%, respectively. After multivariate adjustment, severe prolonged QRS duration was a significant prognostic factor for 30-day in-hospital mortality (hazard ratio, 1.909; 95% confidence interval, 1.024–3.558; p=0.042).
Conclusions
Prolonged QRS duration was associated with a higher risk of 30-day in-hospital mortality among patients with acute HF who presented with CS. Trial Registration: ClinicalTrials.gov Identifier: NCT01389843

Keyword

Heart failure; Cardiogenic shock
Full Text Links
  • IJHF
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr