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Published online: 2021-07-02
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The prevalence and association of major ECG abnormalities with clinical characteristics and the outcomes of real-life heart failure patients—Heart Failure Registries of the ESC

Agata Tymińska, Krzysztof Ozierański, Paweł Balsam, Agnieszka Kapłon-Cieślicka, Cezary Maciejewski, Michał Marchel, Maria G Crespo-Leiro, Aldo P Maggioni, Jarosław Drożdż, Krzysztof J Filipiak, Grzegorz Opolski, Marcin Grabowski
DOI: 10.33963/KP.a2021.0053
·
Pubmed: 34227675

open access

Online first
Original article
Published online: 2021-07-02

Abstract

Background: Electrocardiogram (ECG) abnormalities increase the likelihood of heart failure (HF) but have low specificity and their occurrence is multifactorial. Aims: This study aimed to investigate the prevalence and association of major ECG abnormalities with clinical characteristics and outcomes in a large cohort of real-life HF patients enrolled to HF Registries (Pilot and Long-Term) of the European Society of Cardiology. Methods: Standard 12-lead ECG containing at least one of the following simple parameters was considered a major abnormality: abnormal rhythm; > 100 b.p.m.; QRS ≥120 ms; QTc ≥450 ms; pathological Q-wave; left ventricle hypertrophy; left bundle branch block. A cox proportional hazards regression model was used to identify predictors of the primary (all-cause death) and secondary (all-cause death or hospitalization for worsening HF) endpoints. Results: Patients with abnormal ECG (1222/1460; 83.7%) were older; more frequently were male and had HF with reduced ejection fraction, valvular heart disease, comorbidities, higher New York Heart Association class or higher concentrations of natriuretic peptides than patients with normal ECG. In a one-year observation the primary and secondary endpoints occurred more frequently in patients with abnormal ECG compared to normal ECG (13.8% vs 8.4%; P = 0.021 and 33.0% vs 24.7%; P = 0.016; respectively). Abnormal rhythm, tachycardia, QRS ≥120 ms and QTc ≥450 ms were significant in univariable (both endpoints) analyses but only tachycardia remained an independent predictor of the primary endpoint. Conclusions: HF patients with the major ECG abnormalities were characterized by worse clinical status and one-year outcomes. Only tachycardia was an independent predictor of all-cause death.

Abstract

Background: Electrocardiogram (ECG) abnormalities increase the likelihood of heart failure (HF) but have low specificity and their occurrence is multifactorial. Aims: This study aimed to investigate the prevalence and association of major ECG abnormalities with clinical characteristics and outcomes in a large cohort of real-life HF patients enrolled to HF Registries (Pilot and Long-Term) of the European Society of Cardiology. Methods: Standard 12-lead ECG containing at least one of the following simple parameters was considered a major abnormality: abnormal rhythm; > 100 b.p.m.; QRS ≥120 ms; QTc ≥450 ms; pathological Q-wave; left ventricle hypertrophy; left bundle branch block. A cox proportional hazards regression model was used to identify predictors of the primary (all-cause death) and secondary (all-cause death or hospitalization for worsening HF) endpoints. Results: Patients with abnormal ECG (1222/1460; 83.7%) were older; more frequently were male and had HF with reduced ejection fraction, valvular heart disease, comorbidities, higher New York Heart Association class or higher concentrations of natriuretic peptides than patients with normal ECG. In a one-year observation the primary and secondary endpoints occurred more frequently in patients with abnormal ECG compared to normal ECG (13.8% vs 8.4%; P = 0.021 and 33.0% vs 24.7%; P = 0.016; respectively). Abnormal rhythm, tachycardia, QRS ≥120 ms and QTc ≥450 ms were significant in univariable (both endpoints) analyses but only tachycardia remained an independent predictor of the primary endpoint. Conclusions: HF patients with the major ECG abnormalities were characterized by worse clinical status and one-year outcomes. Only tachycardia was an independent predictor of all-cause death.

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Keywords

cardiac resynchronization therapy, electrocardiogram, QRS duration, left bundle brunch block, heart rhythm

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About this article
Title

The prevalence and association of major ECG abnormalities with clinical characteristics and the outcomes of real-life heart failure patients—Heart Failure Registries of the ESC

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-07-02

DOI

10.33963/KP.a2021.0053

Pubmed

34227675

Keywords

cardiac resynchronization therapy
electrocardiogram
QRS duration
left bundle brunch block
heart rhythm

Authors

Agata Tymińska
Krzysztof Ozierański
Paweł Balsam
Agnieszka Kapłon-Cieślicka
Cezary Maciejewski
Michał Marchel
Maria G Crespo-Leiro
Aldo P Maggioni
Jarosław Drożdż
Krzysztof J Filipiak
Grzegorz Opolski
Marcin Grabowski

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