Electroanatomic ratios and mortality in patients with heart failure: insights from the ASIAN-HF registry
BACKGROUND: QRS duration (QRSd) is a marker of electrical remodeling in heart failure. Anthropometrics and left ventricular size may influence QRSd and, in turn, may influence the association between QRSd and heart failure outcomes. METHODS AND RESULTS: Using the prospective, multicenter, multinatio...
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my.um.eprints.345032022-05-31T08:15:21Z http://eprints.um.edu.my/34503/ Electroanatomic ratios and mortality in patients with heart failure: insights from the ASIAN-HF registry Chyou, Janice Y. Tay, Wan Ting Anand, Inder S. Teng, Tiew-Hwa Katherine Yap, Jonathan J. L. MacDonald, Michael R. Chopra, Vijay Loh, Seet Yoong Shimizu, Wataru Abidin, Imran Zainal Richards, Arthur Mark Butler, Javed Lam, Carolyn S. P. Investigators, ASIAN-HF R Medicine (General) BACKGROUND: QRS duration (QRSd) is a marker of electrical remodeling in heart failure. Anthropometrics and left ventricular size may influence QRSd and, in turn, may influence the association between QRSd and heart failure outcomes. METHODS AND RESULTS: Using the prospective, multicenter, multinational ASIAN-HF (Asian Sudden Cardiac Death in Heart Failure) registry, this study evaluated whether electroanatomic ratios (QRSd indexed for height or left ventricular end-diastole volume) are associated with 1-year mortality in individuals with heart failure with reduced ejection fraction. The study included 4899 individuals (aged 60 +/- 19 years, 78% male, mean left ventricular ejection fraction: 27.3 +/- 7.1%). In the overall cohort, QRSd was not associated with all-cause mortality (hazard ratio HR], 1.003; 95% CI, 0.999-1.006, P=0.142) or sudden cardiac death (HR, 1.006; 95% CI, 1.000-1.013, P=0.059). QRS/height was associated with all-cause mortality (HR, 1.165; 95% CI, 1.046-1.296, P=0.005 with interaction by sex p(interaction)=0.020) and sudden cardiac death (HR, 1.270; 95% CI, 1.021-1.580, P=0.032). QRS/left ventricular end-diastole volume was associated with all-cause mortality (HR, 1.22; 95% CI, 1.05-1.43, P=0.011) and sudden cardiac death (HR, 1.461; 95% CI, 1.090-1.957, P=0.011) in patients with nonischemic cardiomyopathy but not in patients with ischemic cardiomyopathy (all-cause mortality: HR, 0.94; 95% CI, 0.79-1.11, P=0.467; sudden cardiac death: HR, 0.734; 95% CI, 0.477-1.132, P=0.162). CONCLUSIONS: Electroanatomic ratios of QRSd indexed for body size or left ventricular size are associated with mortality in individuals with heart failure with reduced ejection fraction. In particular, increased QRS/height may be a marker of high risk in individuals with heart failure with reduced ejection fraction, and QRS/left ventricular end-diastole volume may further risk stratify individuals with nonischemic heart failure with reduced ejection fraction. Wiley 2021-03-16 Article PeerReviewed Chyou, Janice Y. and Tay, Wan Ting and Anand, Inder S. and Teng, Tiew-Hwa Katherine and Yap, Jonathan J. L. and MacDonald, Michael R. and Chopra, Vijay and Loh, Seet Yoong and Shimizu, Wataru and Abidin, Imran Zainal and Richards, Arthur Mark and Butler, Javed and Lam, Carolyn S. P. and Investigators, ASIAN-HF (2021) Electroanatomic ratios and mortality in patients with heart failure: insights from the ASIAN-HF registry. Journal of The American Heart Association, 10 (6). ISSN 2047-9980, DOI https://doi.org/10.1161/JAHA.120.017932 <https://doi.org/10.1161/JAHA.120.017932>. 10.1161/JAHA.120.017932 |
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R Medicine (General) Chyou, Janice Y. Tay, Wan Ting Anand, Inder S. Teng, Tiew-Hwa Katherine Yap, Jonathan J. L. MacDonald, Michael R. Chopra, Vijay Loh, Seet Yoong Shimizu, Wataru Abidin, Imran Zainal Richards, Arthur Mark Butler, Javed Lam, Carolyn S. P. Investigators, ASIAN-HF Electroanatomic ratios and mortality in patients with heart failure: insights from the ASIAN-HF registry |
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BACKGROUND: QRS duration (QRSd) is a marker of electrical remodeling in heart failure. Anthropometrics and left ventricular size may influence QRSd and, in turn, may influence the association between QRSd and heart failure outcomes. METHODS AND RESULTS: Using the prospective, multicenter, multinational ASIAN-HF (Asian Sudden Cardiac Death in Heart Failure) registry, this study evaluated whether electroanatomic ratios (QRSd indexed for height or left ventricular end-diastole volume) are associated with 1-year mortality in individuals with heart failure with reduced ejection fraction. The study included 4899 individuals (aged 60 +/- 19 years, 78% male, mean left ventricular ejection fraction: 27.3 +/- 7.1%). In the overall cohort, QRSd was not associated with all-cause mortality (hazard ratio HR], 1.003; 95% CI, 0.999-1.006, P=0.142) or sudden cardiac death (HR, 1.006; 95% CI, 1.000-1.013, P=0.059). QRS/height was associated with all-cause mortality (HR, 1.165; 95% CI, 1.046-1.296, P=0.005 with interaction by sex p(interaction)=0.020) and sudden cardiac death (HR, 1.270; 95% CI, 1.021-1.580, P=0.032). QRS/left ventricular end-diastole volume was associated with all-cause mortality (HR, 1.22; 95% CI, 1.05-1.43, P=0.011) and sudden cardiac death (HR, 1.461; 95% CI, 1.090-1.957, P=0.011) in patients with nonischemic cardiomyopathy but not in patients with ischemic cardiomyopathy (all-cause mortality: HR, 0.94; 95% CI, 0.79-1.11, P=0.467; sudden cardiac death: HR, 0.734; 95% CI, 0.477-1.132, P=0.162). CONCLUSIONS: Electroanatomic ratios of QRSd indexed for body size or left ventricular size are associated with mortality in individuals with heart failure with reduced ejection fraction. In particular, increased QRS/height may be a marker of high risk in individuals with heart failure with reduced ejection fraction, and QRS/left ventricular end-diastole volume may further risk stratify individuals with nonischemic heart failure with reduced ejection fraction. |
format |
Article |
author |
Chyou, Janice Y. Tay, Wan Ting Anand, Inder S. Teng, Tiew-Hwa Katherine Yap, Jonathan J. L. MacDonald, Michael R. Chopra, Vijay Loh, Seet Yoong Shimizu, Wataru Abidin, Imran Zainal Richards, Arthur Mark Butler, Javed Lam, Carolyn S. P. Investigators, ASIAN-HF |
author_facet |
Chyou, Janice Y. Tay, Wan Ting Anand, Inder S. Teng, Tiew-Hwa Katherine Yap, Jonathan J. L. MacDonald, Michael R. Chopra, Vijay Loh, Seet Yoong Shimizu, Wataru Abidin, Imran Zainal Richards, Arthur Mark Butler, Javed Lam, Carolyn S. P. Investigators, ASIAN-HF |
author_sort |
Chyou, Janice Y. |
title |
Electroanatomic ratios and mortality in patients with heart failure: insights from the ASIAN-HF registry |
title_short |
Electroanatomic ratios and mortality in patients with heart failure: insights from the ASIAN-HF registry |
title_full |
Electroanatomic ratios and mortality in patients with heart failure: insights from the ASIAN-HF registry |
title_fullStr |
Electroanatomic ratios and mortality in patients with heart failure: insights from the ASIAN-HF registry |
title_full_unstemmed |
Electroanatomic ratios and mortality in patients with heart failure: insights from the ASIAN-HF registry |
title_sort |
electroanatomic ratios and mortality in patients with heart failure: insights from the asian-hf registry |
publisher |
Wiley |
publishDate |
2021 |
url |
http://eprints.um.edu.my/34503/ |
_version_ |
1735409610332831744 |
score |
13.18916 |