Prognostic implications of QRS dispersion for major adverse cardiovascular events in asymptomatic women and men: the Multi-Ethnic Study of Atherosclerosis

Rahul Jain, Sandeep Gautam, Colin Wu, Changyu Shen, Aditya Jain, Ola Giesdal, Harjit Chahal, Hongbo Lin, David A. Bluemke, Elsayed Z. Soliman, Saman Nazarian, João A.C. Lima

Research output: Contribution to journalArticlepeer-review

Abstract

Background: QRS dispersion measured as the difference between maximal and minimal QRS duration in the standard 12-lead electrocardiogram has been shown to be associated with increased mortality in heart failure (HF) patients and increased arrhythmic events in patients with cardiomyopathy. Aims: This study sought to examine the prognostic association between baseline QRS dispersion and future cardiovascular events in individuals without known prior cardiovascular disease. Methods: The association of QRS dispersion with cardiovascular events was examined in 6510 MESA (Multi-Ethnic Study of Atherosclerosis) participants. Participants with bundle branch block were excluded. Study participants were divided into two groups based on the 95th percentile of QRS dispersion (QRS dispersion < 34 ms [group I] and QRS dispersion ≥ 34 ms [group II]). Cox proportional hazard models adjusting for demographic and clinical risk factors were used to examine the association of QRS dispersion with incident cardiovascular events (major adverse cardiovascular events [MACE]) and mortality. Analysis was repeated by forcing Framingham risk factors. Results: Mean age was 62 ± 10 years in group I and 63 ± 10 years in group II (P = 0.02). QRS dispersion ≥ 34 ms was associated significantly with MACE (HR 1.30; 95% CI 1.04–1.62) and mortality (HR 1.33; 95% CI 1.03–1.73) after adjustment for cardiovascular risk factors and potential cofounders. Similar results were seen for mortality after adjustment for Framingham risk factors. Conclusion: QRS dispersion ≥ 34 ms predicts cardiovascular events and mortality.

Original languageEnglish (US)
Pages (from-to)45-53
Number of pages9
JournalJournal of Interventional Cardiac Electrophysiology
Volume56
Issue number1
DOIs
StatePublished - Oct 1 2019

Bibliographical note

Funding Information:
The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org. We acknowledge Mamta Barmeda OT, CHT (Indiana University Health) for help in editing the manuscript.

Funding Information:
This research was supported by contracts N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, and N01-HC-95166, from the National Heart, Lung, and Blood Institute, and by grants UL1-TR-000040 and UL1-TR-001079 from NCRR.

Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.

Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.

Keywords

  • Heart failure
  • Major adverse cardiovascular events
  • Mortality
  • Multi-Ethnic Study of Atherosclerosis
  • QRS dispersion

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