Download The relationship between QRS duration and left ventricular mass

The Relationship between QRS Duration and
Left Ventricular Mass, Volume and Scar
on Cardiac MRI in Patients with Heart Failure
AD. Jakes, CV. Bourantas, E. Lukaschuk, J. Zhang, T. Bragadeesh, K. Wong, A. Clark, JG. Cleland.
University of Hull, Hull York Medical School, Castle Hill Hospital, Department of Cardiology, Hull, United Kingdom
QRS duration is a marker of:
 Conduction
 Myocardial Disease
 Cardiovascular Prognosis
 Cardiac Dyssynchrony
Determinants of QRS duration in heart failure uncertain
200
180
LVEF%
RVEF%
Methods
LV Viable Mass (g/BSA)
Age (Years)
LVEDV (ml/BSA)
 697 patients attending a heart failure clinic
Mean Value and SD
160
-QRS-
140
 CMRI
LVEF
 <35%: 118 (102-146)
120
 35-45%: 106 (98-134)
100
80>45%: 98 (86-100)
60
 Ventricular
mass, volumes and scar mass calculated
40
 Corrected
for body surface area
20
0
 Viable
LV mass calculated by subtracting scar
<100
100-119
120-139
140-159
>160
QRS Duration
(msec)
 Automated measurement
of QRS
(checked manually)
Association of CMR variables and QRS duration
(multiple regression model with 1000 bootstrap samples)
Data shown in order of strength of association
Bootstrap
QRS duration
Age
Normal-based
Std. Err.
0.107
z
5.42
p
<0.001
95% CI
0.372, 0.793
LV Viable Mass
0.034
4.90
<0.001
0.101, 0.236
LVEF
0.130
-4.63
<0.001
-0.856, -0.347
RVEF
0.100
2.70
0.007
0.074, 0.464
Creatinine
0.030
2.29
0.022
0.010, 0.125
RV EDV
0.034
2.17
0.030
0.007, 0.139
Sinus rhythm
2.563
1.94
0.052
-0.048, 10.00
Log (NT-proBNP)
0.993
-1.85
0.064
-3.781, 0.110
Constant
19.48
4.09
<0.001
41.53, 117.9
Conclusions
• LV viable mass, LVEF and Volumes measured by CMRI are
related to QRS duration (univariable analysis)
• But explained little of the variability in QRS duration
(even after correction for BSA)
• Age, but not sex, was associated with QRS duration
• This suggests that QRS duration is influenced more by
conducting disorders and the quality of the myocardium
than either myocardial mass or ventricular volumes.