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ECG variables predict new-onset HF
22 October 2007
MedWire News: Electrocardiogram (ECG) recordings could be used to identify individuals at risk for heart failure (HF), study findings indicate.
Pentti Rautaharju (Wake Forest University, Winston-Salem, North Carolina, USA) and colleagues evaluated use of ECG measures to predict future HF before clinical signs of coronary heart disease (CHD) are present in 13,555 participants of the ongoing ARIC (Atherosclerosis risk in communities) study.
The participants were aged 45 to 65 years at the 1987 to 1989 baseline examination, and were free from CHD. The presence of HF was defined as hospitalization and discharge diagnosis for HF.
Multivariate analysis accounting for demographic and clinical variables revealed that a wide QRS/T angle (≥107° in men, ≥89° in women) and an increased heart rate (>77 beats/min in men, >79 beats/min in women) significantly predicted HF in both men and women, each conferring an approximately 30% increased risk for new-onset HF.
Old silent myocardial infarction (as defined by novacode criteria), increased ECG-left ventricular mass (≥204 g), ST depression in lead V5 (<5 礦), and prolonged QTrr interval (>436 ms) were significant predictors of HF only in men (relative risks [RRs]=1.59, 2.01, 1.57, and 1.99, respectively).
\"These ECG abnormalities are likely to be manifestations of evolving CHD or left ventricular hypertrophy,\" the team comments.
In women, but not in men, QRS nondipolar voltage was the strongest independent predictor of HF (RR=1.87). The researchers note that \"the reason for this gender difference is unknown,\" as there is no evidence suggesting that women are more likely than men to suffer depolarization abnormalities.
Rautaharju and co-workers conclude in the American Journal of Cardiology: \"Several ECG abnormalities are manifestations of evolving HF in men and women considered free of CHD.\"
Am J Cardiol 2007; 100: 1437-1441 |
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发表于 2007-10-29 07:42:28