TY - JOUR
T1 - Associations between left bundle branch block with different PR intervals, QRS durations, heart rates and the risk of heart failure
T2 - a register-based cohort study using ECG data from the primary care setting
AU - Søndergaard, Marc Meller
AU - Riis, Johannes
AU - Bodker, Karoline Willum
AU - Hansen, Steen Møller
AU - Nielsen, Jesper
AU - Graff, Claus
AU - Pietersen, Adrian Holger
AU - Nielsen, Jonas Bille
AU - Tayal, Bhupendar
AU - Polcwiartek, Christoffer
AU - Torp-Pedersen, Christian
AU - Soegaard, Peter
AU - Kragholm, Kristian Hay
N1 - © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2021/2
Y1 - 2021/2
N2 - AIM: Left bundle branch block (LBBB) is associated with an increased risk of heart failure (HF). We assessed the impact of common ECG parameters on this association using large-scale data.METHODS AND RESULTS: Using ECGs recorded in a large primary care population from 2001 to 2011, we identified HF-naive patients with a first-time LBBB ECG. We obtained information on sex, age, emigration, medication, diseases and death from Danish registries. We investigated the association between the PR interval, QRS duration, and heart rate and the risk of HF over a 2-year follow-up period using Cox regression analysis.Of 2471 included patients with LBBB, 464 (18.8%) developed HF during follow-up. A significant interaction was found between QRS duration and heart rate (p<0.01), and the analyses were stratified on these parameters. Using a QRS duration <150 ms and a heart rate <70 beats per minute (bpm) as the reference, all groups were statistically significantly associated with the development of HF. Patients with a QRS duration ≥150 ms and heart rate ≥70 bpm had the highest risk of developing HF (HR 3.17 (95% CI 2.41 to 4.18, p<0.001). There was no association between the PR interval and HF after adjustment.CONCLUSION: Prolonged QRS duration and higher heart rate were associated with increased risk of HF among primary care patients with LBBB, while no association was observed with PR interval. Patients with LBBB with both a prolonged QRS duration (≥150 ms) and higher heart rate (≥70 bpm) have the highest risk of developing HF.
AB - AIM: Left bundle branch block (LBBB) is associated with an increased risk of heart failure (HF). We assessed the impact of common ECG parameters on this association using large-scale data.METHODS AND RESULTS: Using ECGs recorded in a large primary care population from 2001 to 2011, we identified HF-naive patients with a first-time LBBB ECG. We obtained information on sex, age, emigration, medication, diseases and death from Danish registries. We investigated the association between the PR interval, QRS duration, and heart rate and the risk of HF over a 2-year follow-up period using Cox regression analysis.Of 2471 included patients with LBBB, 464 (18.8%) developed HF during follow-up. A significant interaction was found between QRS duration and heart rate (p<0.01), and the analyses were stratified on these parameters. Using a QRS duration <150 ms and a heart rate <70 beats per minute (bpm) as the reference, all groups were statistically significantly associated with the development of HF. Patients with a QRS duration ≥150 ms and heart rate ≥70 bpm had the highest risk of developing HF (HR 3.17 (95% CI 2.41 to 4.18, p<0.001). There was no association between the PR interval and HF after adjustment.CONCLUSION: Prolonged QRS duration and higher heart rate were associated with increased risk of HF among primary care patients with LBBB, while no association was observed with PR interval. Patients with LBBB with both a prolonged QRS duration (≥150 ms) and higher heart rate (≥70 bpm) have the highest risk of developing HF.
KW - 12 lead ECG
KW - Epidemiology
KW - Primary care
UR - http://www.scopus.com/inward/record.url?scp=85100831298&partnerID=8YFLogxK
U2 - 10.1136/openhrt-2020-001425
DO - 10.1136/openhrt-2020-001425
M3 - Journal article
C2 - 33574021
VL - 8
JO - Open Heart
JF - Open Heart
SN - 2053-3624
IS - 1
M1 - e001425.
ER -