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首页> 外文期刊>The American Journal of Cardiology >QRS duration on electrocardiography and cardiovascular mortality (from the national health and nutrition examination survey - III)
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QRS duration on electrocardiography and cardiovascular mortality (from the national health and nutrition examination survey - III)

机译：QRS持续时间对心电图和心血管疾病的死亡率（来自国家健康和营养检查调查-III）

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The relation of bundle branch block (BBB) with adverse outcome is controversial. We hypothesized that increased QRS duration is an independent predictor of cardiovascular (CV) mortality in a cross-sectional US population. This is a retrospective cohort study on prospectively collected data to assess the relationship between QRS duration on routine ECG and CV mortality. Participants included 8,527 patients with ECG data available from the National Health and Nutrition Examination Survey data set, representing 74,062,796 individuals in the United States. Mean age was 60.5 ± 13.6 years. Most subjects were white (87%) and women (53%). During the follow-up period of 106,244.6 person-years, 1,433 CV deaths occurred. Multivariate analysis revealed that the highest quartile of QRS duration was associated with higher CV mortality than lowest quartile (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.01 to 1.7, p = 0.04) after adjustment for established risk factors. Both left BBB (HR 2.4, 95% CI 1.3 to 4.7, p = 0.009) and right BBB (HR 1.90, 95% CI 1.2 to 3.0, p = 0.008) were significantly associated with increased CV mortality. The addition of the QRS duration in 10-millisecond increments to the Framingham Risk Score model resulted in 4.4% overall net reclassification improvement (95% CI 0.02 to 0.04; p = 0.00006). In conclusion, increased QRS duration was found to be an independent predictor of CV mortality in this cross-sectional US population. A model including QRS duration in addition to traditional risk factors was associated with improved CV risk prediction.
机译：束支传导阻滞（BBB）与不良结局的关系尚存争议。我们假设增加QRS持续时间是美国横断面人群中心血管（CV）死亡率的独立预测因子。这是一项针对前瞻性收集数据的回顾性队列研究，目的是评估QRS持续时间对常规ECG和CV死亡率之间的关系。参加者包括8,527名患者的心电图数据，这些患者可从美国国家健康和营养检查调查数据集中获得，代表美国的74,062,796个人。平均年龄为60.5±13.6岁。大多数受试者为白人（87％）和女性（53％）。在106,244.6人年的随访期间，发生了1,433例CV死亡。多变量分析显示，在对已确定的危险因素进行调整后，QRS持续时间的最高四分位数与最低四分位数相关的CV死亡率较高（危险比[HR] 1.3，95％置信区间[CI] 1.01至1.7，p = 0.04）。左BBB（HR 2.4，95％CI 1.3至4.7，p = 0.009）和右BBB（HR 1.90，95％CI 1.2至3.0，p = 0.008）与CV死亡率增加显着相关。在Framingham风险评分模型中以10毫秒为增量增加QRS持续时间可带来4.4％的总体净重分类改善（95％CI 0.02至0.04; p = 0.00006）。总而言之，发现QRS持续时间的增加是该横截面美国人群CV死亡率的独立预测因子。除传统风险因素外，还包括QRS持续时间的模型与改善的CV风险预测相关。

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