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

doi:10.1007/s10840-019-00614-y

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

Medicine - Hematology, Oncology, Transplant

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

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 language	English (US)
Pages (from-to)	45-53
Number of pages	9
Journal	Journal of Interventional Cardiac Electrophysiology
Volume	56
Issue number	1
DOIs	https://doi.org/10.1007/s10840-019-00614-y
State	Published - 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.

Keywords

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

PubMed: MeSH publication types

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Jain, R., Gautam, S., Wu, C., Shen, C., Jain, A., Giesdal, O., Chahal, H., Lin, H., Bluemke, D. A., Soliman, E. Z., Nazarian, S., & Lima, J. A. C. (2019). Prognostic implications of QRS dispersion for major adverse cardiovascular events in asymptomatic women and men: the Multi-Ethnic Study of Atherosclerosis. Journal of Interventional Cardiac Electrophysiology, 56(1), 45-53. https://doi.org/10.1007/s10840-019-00614-y

Jain, R, Gautam, S, Wu, C, Shen, C, Jain, A, Giesdal, O, Chahal, H, Lin, H, Bluemke, DA, Soliman, EZ, Nazarian, S & Lima, JAC 2019, 'Prognostic implications of QRS dispersion for major adverse cardiovascular events in asymptomatic women and men: the Multi-Ethnic Study of Atherosclerosis', Journal of Interventional Cardiac Electrophysiology, vol. 56, no. 1, pp. 45-53. https://doi.org/10.1007/s10840-019-00614-y

@article{dfa0555713a549389afa4287b9900c78,

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

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.",

keywords = "Heart failure, Major adverse cardiovascular events, Mortality, Multi-Ethnic Study of Atherosclerosis, QRS dispersion",

author = "Rahul Jain and Sandeep Gautam and Colin Wu and Changyu Shen and Aditya Jain and Ola Giesdal and Harjit Chahal and Hongbo Lin and Bluemke, {David A.} and Soliman, {Elsayed Z.} and Saman Nazarian and Lima, {Jo{\~a}o A.C.}",

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: {\textcopyright} 2019, Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2019",

month = oct,

day = "1",

doi = "10.1007/s10840-019-00614-y",

language = "English (US)",

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pages = "45--53",

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TY - JOUR

T1 - Prognostic implications of QRS dispersion for major adverse cardiovascular events in asymptomatic women and men

T2 - the Multi-Ethnic Study of Atherosclerosis

AU - Jain, Rahul

AU - Gautam, Sandeep

AU - Wu, Colin

AU - Shen, Changyu

AU - Jain, Aditya

AU - Giesdal, Ola

AU - Chahal, Harjit

AU - Lin, Hongbo

AU - Bluemke, David A.

AU - Soliman, Elsayed Z.

AU - Nazarian, Saman

AU - Lima, João A.C.

N1 - 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.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - 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.

AB - 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.

KW - Heart failure

KW - Major adverse cardiovascular events

KW - Mortality

KW - Multi-Ethnic Study of Atherosclerosis

KW - QRS dispersion

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U2 - 10.1007/s10840-019-00614-y

DO - 10.1007/s10840-019-00614-y

M3 - Article

C2 - 31482330

AN - SCOPUS:85071781880

SN - 1383-875X

VL - 56

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EP - 53

JO - Journal of Interventional Cardiac Electrophysiology

JF - Journal of Interventional Cardiac Electrophysiology

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ER -

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

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

Publisher link

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