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Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study.

Publication ,  Journal Article
Mentz, RJ; Greiner, MA; DeVore, AD; Dunlay, SM; Choudhary, G; Ahmad, T; Khazanie, P; Randolph, TC; Griswold, ME; Eapen, ZJ; O'Brien, EC ...
Published in: Circ Heart Fail
March 2015

BACKGROUND: QRS prolongation is associated with adverse outcomes in mostly white populations, but its clinical significance is not well established for other groups. We investigated the association between QRS duration and mortality in African Americans. METHODS AND RESULTS: We analyzed data from 5146 African Americans in the Jackson Heart Study stratified by QRS duration on baseline 12-lead ECG. We defined QRS prolongation as QRS≥100 ms. We assessed the association between QRS duration and all-cause mortality using Cox proportional hazards models and reported the cumulative incidence of heart failure hospitalization. We identified factors associated with the development of QRS prolongation in patients with normal baseline QRS. At baseline, 30% (n=1528) of participants had QRS prolongation. The cumulative incidences of mortality and heart failure hospitalization were greater with versus without baseline QRS prolongation: 12.6% (95% confidence interval [CI], 11.0-14.4) versus 7.1% (95% CI, 6.3-8.0) and 8.2% (95% CI, 6.9-9.7) versus 4.4% (95% CI, 3.7-5.1), respectively. After risk adjustment, QRS prolongation was associated with increased mortality (hazard ratio, 1.27; 95% CI, 1.03-1.56; P=0.02). There was a linear relationship between QRS duration and mortality (hazard ratio per 10 ms increase, 1.06; 95% CI, 1.01-1.12). Older age, male sex, prior myocardial infarction, lower ejection fraction, left ventricular hypertrophy, and left ventricular dilatation were associated with the development of QRS prolongation. CONCLUSIONS: QRS prolongation in African Americans was associated with increased mortality and heart failure hospitalization. Factors associated with developing QRS prolongation included age, male sex, prior myocardial infarction, and left ventricular structural abnormalities.

Duke Scholars

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

March 2015

Volume

8

Issue

2

Start / End Page

243 / 251

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Treatment Outcome
  • Stroke Volume
  • Risk Factors
  • Proportional Hazards Models
  • Observational Studies as Topic
  • Middle Aged
  • Male
  • Hypertrophy, Left Ventricular
  • Humans
 

Citation

APA
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ICMJE
MLA
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Mentz, R. J., Greiner, M. A., DeVore, A. D., Dunlay, S. M., Choudhary, G., Ahmad, T., … Hernandez, A. F. (2015). Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study. Circ Heart Fail, 8(2), 243–251. https://doi.org/10.1161/CIRCHEARTFAILURE.114.001729
Mentz, Robert J., Melissa A. Greiner, Adam D. DeVore, Shannon M. Dunlay, Gaurav Choudhary, Tariq Ahmad, Prateeti Khazanie, et al. “Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study.Circ Heart Fail 8, no. 2 (March 2015): 243–51. https://doi.org/10.1161/CIRCHEARTFAILURE.114.001729.
Mentz RJ, Greiner MA, DeVore AD, Dunlay SM, Choudhary G, Ahmad T, et al. Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study. Circ Heart Fail. 2015 Mar;8(2):243–51.
Mentz, Robert J., et al. “Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study.Circ Heart Fail, vol. 8, no. 2, Mar. 2015, pp. 243–51. Pubmed, doi:10.1161/CIRCHEARTFAILURE.114.001729.
Mentz RJ, Greiner MA, DeVore AD, Dunlay SM, Choudhary G, Ahmad T, Khazanie P, Randolph TC, Griswold ME, Eapen ZJ, O’Brien EC, Thomas KL, Curtis LH, Hernandez AF. Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study. Circ Heart Fail. 2015 Mar;8(2):243–251.

Published In

Circ Heart Fail

DOI

EISSN

1941-3297

Publication Date

March 2015

Volume

8

Issue

2

Start / End Page

243 / 251

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Treatment Outcome
  • Stroke Volume
  • Risk Factors
  • Proportional Hazards Models
  • Observational Studies as Topic
  • Middle Aged
  • Male
  • Hypertrophy, Left Ventricular
  • Humans