Prognostic significance of quantitative QRS duration
Prognostic significance of quantitative QRS duration
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DOI：
10.1016/j.amjmed.2005.08.028
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发表时间：
2006-07-01
影响因子：
5.9
通讯作者：
Froelicher, Victor F.
中科院分区：
文献类型：
--
作者：
Desai, Aseem D.;Yaw, Tan Swee;Froelicher, Victor F.
背景技术背景：虽然QRS波时限是已知的左心室功能不全患者的死亡率的预测因子，我们的目的是评估计算机测量的QRS波时限在一般的医疗population.METHODS的预后能力：分析进行了第一次心电图数字记录46,933连续患者在帕洛阿尔托退伍军人事务医疗中心1987年和2000年之间。排除心电图显示Wolff-Parkinson-白色的患者（n = 44），单独考虑束分支传导阻滞或电子起搏的患者，留下44，280例患者进行分析（平均年龄56 ± 15岁; 90%为男性）。有3659例（8.3%）心血管死亡（平均随访6.0 +/- 3.8年）。在考克斯模型中校正年龄、性别和心率后，QRS时限评分是心血管死亡率的一个强有力的独立预测因子。QRS波持续时间每增加10 ms，心血管风险增加18%。结果是相似的患者异常心电图，束分支阻滞，和起搏rhythm.CONCLUSION：定量QRS时限是一个显着的和独立的预测心血管疾病的死亡率在一般医疗人群。(c)2006年爱思唯尔公司All rights reserved.
BACKGROUND: Although QRS duration is known to be a predictor of mortality in patients with left ventricular dysfunction, our purpose was to evaluate the prognostic power of computer-measured QRS duration in a general medical population.METHODS: Analyses were performed on the first electrocardiogram digitally recorded on 46,933 consecutive patients at the Palo Alto Veterans Affairs Medical Center between 1987 and 2000. Patients with electrocardiograms exhibiting Wolff-Parkinson-White were excluded (n = 44), and those with bundle branch block or electronic pacing were considered separately, leaving 44,280 patients for analysis (mean age 56 +/- 15 years; 90% were males). There were 3659 (8.3%) cardiovascular deaths (mean follow-up of 6.0 +/- 3.8 years).RESULTS: A survival plot showed significant separation according to a QRS duration score. After adjustment in the Cox model for age, gender, and heart rate, the QRS duration score was a strong independent predictor of cardiovascular mortality. For every 10-ms increase in QRS duration, there was an 18% increase in cardiovascular risk. The results were similar in patients with an abnormal electrocardiogram, a bundle branch block, and a paced rhythm.CONCLUSION: Quantitative QRS duration was a significant and independent predictor of cardiovascular mortality in a general medical population. (c) 2006 Elsevier Inc. All rights reserved.