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.
