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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.