Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: Insights from the Jackson heart study

Robert J. Mentz, Melissa A. Greiner, Adam D. Devore, Shannon M Dunlay, Gaurav Choudhary, Tariq Ahmad, Prateeti Khazanie, Tiffany C. Randolph, Michael E. Griswold, Zubin J. Eapen, Emily C. O'Brien, Kevin L. Thomas, Lesley H. Curtis, Adrian F. Hernandez

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)243-251
Number of pages9
JournalCirculation: Heart Failure
Volume8
Issue number2
DOIs
StatePublished - Mar 20 2015

Keywords

  • African American
  • heart failure
  • mortality
  • ventricular conduction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: Insights from the Jackson heart study'. Together they form a unique fingerprint.

  • Cite this

    Mentz, R. J., Greiner, M. A., Devore, A. D., Dunlay, S. M., Choudhary, G., Ahmad, T., Khazanie, P., Randolph, T. C., Griswold, M. E., Eapen, Z. J., O'Brien, E. C., Thomas, K. L., Curtis, L. H., & Hernandez, A. F. (2015). Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: Insights from the Jackson heart study. Circulation: Heart Failure, 8(2), 243-251. https://doi.org/10.1161/CIRCHEARTFAILURE.114.001729