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PROHLÍŽENÍ ABSTRAKTA

NATIVE QRS DURATION AND OUTCOMES IN HEART FAILURE WITH MILDLY REDUCED EJECTION FRACTION: RESULTS FROM A LARGE-SCALED REGISTRY
Tématický okruh: Srdeční selhání, transplantace, oběhové podpory
Typ: Ústní sdělení - lékařské , Číslo v programu: 4
Schupp T.1, Kronberg F.1, Reinhardt M.1, Abel N.1, Schmitt A.1, Lau F.1, Bertsch T.2, Steffen H.1, Weidner K.1, Abumayyaleh M.1, Kuschyk J.1, Behnes M.1, Akin I.3

1 First Department of Medicine, University Medical Centre Mannheim, Mannheim, Germany, 2 Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Nuremberg General Hospital, Nurmeberg, Germany, 3 ., University Mannheim, Mannheim, Germany


Objective: The study investigates the prognostic impact of the native QRS duration in patients with heart failure with mildly reduced ejection fraction (HFmrEF).
Background: The prognostic impact of QRS duration in HFmrEF has poorly been investigated.
Methods: Consecutive patients with HFmrEF 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 amongst others the risk of HF-related rehospitalization.
Results: In total, 1,627 patients with HFmrEF were included with a median QRS duration of 90 ms (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 rehospitalization for worsening HF (18.2% vs. 11.9%; p = 0.008; HR = 1.574; 95% CI 1.124 – 2.204), even after multivariable adjustment. A QRS duration ≥120 ms was associated with long-term HF-related rehospitalization even after multivariable adjustment (HR 1.413, 95% CI 1.002 – 1.992, p = 0.049). 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 QRS duration is independently associated with a higher risk of HF-related rehospitalization in HFmrEF, but not long-term all-cause mortality.