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.

UN SDGs

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

SDG 3 Good Health and Well-being

Keywords

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

PubMed: MeSH publication types

Journal Article

Publisher link

10.1007/s10840-019-00614-y

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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",

journal = "Journal of Interventional Cardiac Electrophysiology",

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number = "1",

}

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

UR - https://www.scopus.com/pages/publications/85071781880

UR - https://www.scopus.com/pages/publications/85071781880#tab=citedBy

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

SP - 45

EP - 53

JO - Journal of Interventional Cardiac Electrophysiology

JF - Journal of Interventional Cardiac Electrophysiology

IS - 1

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

UN SDGs

Keywords

PubMed: MeSH publication types

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