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Objective <p>The study investigates the prognostic impact of the native QRS duration in patients with heart failure and mildly reduced ejection fraction (HFmrEF).</p> Background <p>The prognostic impact of QRS duration in HFmrEF has rarely been investigated.</p> Methods <p>Consecutive patients with HFmrEF and available 12-lead electrocardiogram were retrospectively included at one institution from 2016 to 2022. Patients with QRS duration ≥ 120&#xa0;ms were compared to patients with QRS duration &lt; 120&#xa0;ms, further risk stratification was performed comparing patients with left and right bundle branch block (LBBB vs. RBBB). The primary endpoint was all-cause mortality at 30&#xa0;months, secondary endpoints comprised the risk of HF-related rehospitalization.</p> Results <p>In total, 1627 patients with HFmrEF were included with a median QRS duration of 90&#xa0;ms (i.e., QRS duration ≥ 120&#xa0;ms: 15%). Although the risk of long-term all-cause mortality was not affected by a prolonged QRS duration (35.1% vs. 28.7%; p = 0.057; HR = 1.254; 95% CI 0.993–1.583), patients with QRS duration ≥ 120&#xa0;ms had a higher risk of HF-related rehospitalization (18.2% vs. 11.9%; p = 0.008; HR = 1.574; 95% CI 1.124–2.204). A QRS duration ≥ 120&#xa0;ms was associated with long-term HF-related rehospitalization even after multivariable adjustment (HR 1.420, 95% CI 1.008–2.002, p = 0.045). Finally, the risks of long-term all-cause mortality and HF-related rehospitalization did not differ among patients with LBBB and RBBB.</p> Conclusion <p>A prolonged native QRS duration is independently associated with a higher risk of HF-related rehospitalization in HFmrEF, but not long-term all-cause mortality.</p> Graphical abstract <p></p>

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Native QRS duration and outcomes in heart failure with mildly reduced ejection fraction: results from a large-scaled registry

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月12日

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  • Finn Ole Kronberg,
  • Michael Behnes,
  • Marielen Reinhardt,
  • Noah Abel,
  • Alexander Schmitt,
  • Felix Lau,
  • Thomas Bertsch,
  • Henning Johann Steffen,
  • Kathrin Weidner,
  • Mohammad Abumayyaleh,
  • Jürgen Kuschyk,
  • Ibrahim Akin,
  • Tobias Schupp

摘要

Objective

The study investigates the prognostic impact of the native QRS duration in patients with heart failure and mildly reduced ejection fraction (HFmrEF).

Background

The prognostic impact of QRS duration in HFmrEF has rarely been investigated.

Methods

Consecutive patients with HFmrEF and available 12-lead electrocardiogram were retrospectively included at one institution from 2016 to 2022. Patients with QRS duration ≥ 120 ms were compared to patients with QRS duration < 120 ms, further risk stratification was performed comparing patients with left and right bundle branch block (LBBB vs. RBBB). The primary endpoint was all-cause mortality at 30 months, secondary endpoints comprised the risk of HF-related rehospitalization.

Results

In total, 1627 patients with HFmrEF were included with a median QRS duration of 90 ms (i.e., QRS duration ≥ 120 ms: 15%). Although the risk of long-term all-cause mortality was not affected by a prolonged QRS duration (35.1% vs. 28.7%; p = 0.057; HR = 1.254; 95% CI 0.993–1.583), patients with QRS duration ≥ 120 ms had a higher risk of HF-related rehospitalization (18.2% vs. 11.9%; p = 0.008; HR = 1.574; 95% CI 1.124–2.204). A QRS duration ≥ 120 ms was associated with long-term HF-related rehospitalization even after multivariable adjustment (HR 1.420, 95% CI 1.008–2.002, p = 0.045). Finally, the risks of long-term all-cause mortality and HF-related rehospitalization did not differ among patients with LBBB and RBBB.

Conclusion

A prolonged native QRS duration is independently associated with a higher risk of HF-related rehospitalization in HFmrEF, but not long-term all-cause mortality.

Graphical abstract