European Journal of Heart Failure (2014) 16, 639–647 doi:10.1002/ejhf.63
Prevalence and clinical impact of QRS duration in patients with low-flow/low-gradient aortic stenosis due to left ventricular systolic dysfunction Frédéric A. Sebag, Nicolas Lellouche, Najia Chaachoui, Jean-Luc Dubois-Rande, Pascal Gueret, and Jean-Luc Monin* Department of Cardiology, Henri Mondor Hospital (Assistance Publique-Hôpitaux de Paris), Creteil, France Received 30 September 2013; revised 3 December 2013; accepted 13 January 2014 ; online publish-ahead-of-print 18 February 2014
Aims
To evaluate the prognostic impact of QRS width in patients with low-flow/low-gradient aortic stenosis (LF/LGAS). ..................................................................................................................................................................... Methods Among 88 consecutive patients referred to our institution for LF/LGAS from September 1994 to March 2007, and results baseline demographic, clinical, echocardiographic, and electrocardiographic data were collected. This population was divided into two groups according to baseline QRS duration (cut-off QRS ≥130 ms). Follow-up data, including electrocardiographic evolution and overall mortality, were analysed. The mean follow-up duration was 3.1 (2.2–6.2) years. In the whole group, 67 patients underwent surgical aortic valve replacement. Forty-nine patients (56%) had a QRS duration ≥130 ms. Among operated patients, there was no significant change in QRS duration between baseline and latest follow-up (126 ± 26 ms vs. 131 ± 25 ms; P = 0.82). In addition, wider QRS was a strong independent predictor of overall mortality (hazard ratio 2.20, 95% confidence interval 1.15–4.24; P = 0.027). ..................................................................................................................................................................... Conclusion Significant intraventricular conduction disturbances are common in patients with LF/LGAS and do not recover after aortic valve replacement. QRS duration is strongly associated with mortality in this selected population.
.......................................................................................................... Bundle branch block • Low-flow/low-gradient aortic stenosis • Intraventricular conduction
Introduction Aortic stenosis (AS) is currently the most frequent native valvular heart disease in western countries.1 Among patients with presumably severe AS,
Prevalence and clinical impact of QRS duration in patients with low-flow/low-gradient aortic stenosis due to left ventricular systolic dysfunction Frédéric A. Sebag, Nicolas Lellouche, Najia Chaachoui, Jean-Luc Dubois-Rande, Pascal Gueret, and Jean-Luc Monin* Department of Cardiology, Henri Mondor Hospital (Assistance Publique-Hôpitaux de Paris), Creteil, France Received 30 September 2013; revised 3 December 2013; accepted 13 January 2014 ; online publish-ahead-of-print 18 February 2014
Aims
To evaluate the prognostic impact of QRS width in patients with low-flow/low-gradient aortic stenosis (LF/LGAS). ..................................................................................................................................................................... Methods Among 88 consecutive patients referred to our institution for LF/LGAS from September 1994 to March 2007, and results baseline demographic, clinical, echocardiographic, and electrocardiographic data were collected. This population was divided into two groups according to baseline QRS duration (cut-off QRS ≥130 ms). Follow-up data, including electrocardiographic evolution and overall mortality, were analysed. The mean follow-up duration was 3.1 (2.2–6.2) years. In the whole group, 67 patients underwent surgical aortic valve replacement. Forty-nine patients (56%) had a QRS duration ≥130 ms. Among operated patients, there was no significant change in QRS duration between baseline and latest follow-up (126 ± 26 ms vs. 131 ± 25 ms; P = 0.82). In addition, wider QRS was a strong independent predictor of overall mortality (hazard ratio 2.20, 95% confidence interval 1.15–4.24; P = 0.027). ..................................................................................................................................................................... Conclusion Significant intraventricular conduction disturbances are common in patients with LF/LGAS and do not recover after aortic valve replacement. QRS duration is strongly associated with mortality in this selected population.
.......................................................................................................... Bundle branch block • Low-flow/low-gradient aortic stenosis • Intraventricular conduction
Introduction Aortic stenosis (AS) is currently the most frequent native valvular heart disease in western countries.1 Among patients with presumably severe AS,
