Diagnostic and prognostic value of QRS duration and QTc
interval in patients with suspected myocardial infarction

J 2018

Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction

CUPA, J., I. STREBEL, P. BADERTSCHER, R. ABACHERLI, R. TWERENBOLD et. al.

Základní údaje

Originální název

Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction

Autoři

CUPA, J. (756 Švýcarsko), I. STREBEL (756 Švýcarsko), P. BADERTSCHER (756 Švýcarsko), R. ABACHERLI (756 Švýcarsko), R. TWERENBOLD (756 Švýcarsko), L. SCHUMACHER (756 Švýcarsko), J. BOEDDINGHAUS (756 Švýcarsko), T. NESTELBERGER (756 Švýcarsko), P. MAECHLER (756 Švýcarsko), N. KOZHUHAROV (756 Švýcarsko), M.R. GIMENEZ (756 Švýcarsko), K. WILDI (756 Švýcarsko), J.D. de LAVALLAZ (756 Švýcarsko), Z. SABTI (756 Švýcarsko), L. SAZGARY (756 Švýcarsko), C. PUELACHER (756 Švýcarsko), D. MUELLER (756 Švýcarsko), C. BIANCI (756 Švýcarsko), O. MIRO (756 Švýcarsko), C. FUENZALIDA (724 Španělsko), S. CALDERON (724 Španělsko), F.J. MARTIN-SANCHEZ (724 Španělsko), S.L. IGLESIAS (724 Španělsko), B. MORAWIEE (616 Polsko), D. KAWECKR (616 Polsko), Jiří PAŘENICA (203 Česká republika, domácí), D.I. KELLER (756 Švýcarsko), N. GEIGY (756 Švýcarsko), S. OSSWALD (756 Švýcarsko), C. MUELLER (756 Švýcarsko) a T. REICHLIN (756 Švýcarsko, garant)

Vydání

CARDIOLOGY JOURNAL, GDANSK, VIA MEDICA, 2018, 1897-5593

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Polsko

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 1.743

Kód RIV

RIV/00216224:14110/18:00104901

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.5603/CJ.a2018.0033

UT WoS

000449351400009

Klíčová slova anglicky

QRS duration; QTc interval; chest pain

Štítky

14110211, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 9. 2. 2019 22:05, Soňa Böhmová

Anotace

V originále

Background: While prolongation of QRS duration and QTc interval during acute myocardial infarction (AMI) has been reported in animals, limited data is available for these readily available electrocardiography (ECG) markers in humans. Methods: Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected AMI in a prospective diagnostic multicentre study were prospectively assessed, Digital 12-lead ECGs were recorded at presentation. QRS duration and QTc interval were automatically calculated in a blinded fashion. Final diagnosis was adjudicated by two independent cardiologists. The prognostic endpoint was all-cause mortality during 24 months of follow-up. Results: Among 4042 patients, AMI was the final diagnosis in 19% of patients. Median QRS duration and median QTc interval were significantly greater in patients with AMI compared to those with other final diagnoses (98 ms (IQR 88-108] vs. 94 ms [IQR 86-102] and 436 ms [IQR 414-462] vs. 425 ms [IQR 407-445], p < 0.001 for both comparisons). The diagnostic value of both ECG signatures however was only modest (AUC 0.56 and 0.60). Cumulative mortality rates after 2 years were 15.9% vs. 5.6% in patients with a QRS > 120 ms compared to a QRS duration <= 120 ms (p < 0.001), and 11.4% vs. 4.3% in patients with a QTc > 440 ms compared to a QRS duration <= 440 ms (p < 0.001). After adjustment for age and important ECG and clinical parameters, the QTc interval but not QRS duration remained an independent predictor of mortality. Conclusions: Prolongation of QRS duration > 120 ms and QTc interval > 440 ms predict mortality in patients with suspected AMI, but do not add diagnostic value.

Citovat

CUPA, J., I. STREBEL, P. BADERTSCHER, R. ABACHERLI, R. TWERENBOLD, L. SCHUMACHER, J. BOEDDINGHAUS, T. NESTELBERGER, P. MAECHLER, N. KOZHUHAROV, M.R. GIMENEZ, K. WILDI, J.D. de LAVALLAZ, Z. SABTI, L. SAZGARY, C. PUELACHER, D. MUELLER, C. BIANCI, O. MIRO, C. FUENZALIDA, S. CALDERON, F.J. MARTIN-SANCHEZ, S.L. IGLESIAS, B. MORAWIEE, D. KAWECKR, Jiří PAŘENICA, D.I. KELLER, N. GEIGY, S. OSSWALD, C. MUELLER a T. REICHLIN. Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction. CARDIOLOGY JOURNAL. GDANSK: VIA MEDICA, 2018, roč. 25, č. 5, s. 601-610. ISSN 1897-5593. Dostupné z: https://dx.doi.org/10.5603/CJ.a2018.0033.

@article{1477977,
   author = {Cupa, J. and Strebel, I. and Badertscher, P. and Abacherli, R. and Twerenbold, R. and Schumacher, L. and Boeddinghaus, J. and Nestelberger, T. and Maechler, P. and Kozhuharov, N. and Gimenez, M.R. and Wildi, K. and Lavallaz, J.D. de and Sabti, Z. and Sazgary, L. and Puelacher, C. and Mueller, D. and Bianci, C. and Miro, O. and Fuenzalida, C. and Calderon, S. and MartinandSanchez, F.J. and Iglesias, S.L. and Morawiee, B. and Kaweckr, D. and Pařenica, Jiří and Keller, D.I. and Geigy, N. and Osswald, S. and Mueller, C. and Reichlin, T.},
   article_location = {GDANSK},
   article_number = {5},
   doi = {http://dx.doi.org/10.5603/CJ.a2018.0033},
   keywords = {QRS duration; QTc interval; chest pain},
   language = {eng},
   issn = {1897-5593},
   journal = {CARDIOLOGY JOURNAL},
   title = {Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction},
   volume = {25},
   year = {2018}
}

TY  - JOUR
ID  - 1477977
AU  - Cupa, J. - Strebel, I. - Badertscher, P. - Abacherli, R. - Twerenbold, R. - Schumacher, L. - Boeddinghaus, J. - Nestelberger, T. - Maechler, P. - Kozhuharov, N. - Gimenez, M.R. - Wildi, K. - Lavallaz, J.D. de - Sabti, Z. - Sazgary, L. - Puelacher, C. - Mueller, D. - Bianci, C. - Miro, O. - Fuenzalida, C. - Calderon, S. - Martin-Sanchez, F.J. - Iglesias, S.L. - Morawiee, B. - Kaweckr, D. - Pařenica, Jiří - Keller, D.I. - Geigy, N. - Osswald, S. - Mueller, C. - Reichlin, T.
PY  - 2018
TI  - Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction
JF  - CARDIOLOGY JOURNAL
VL  - 25
IS  - 5
SP  - 601-610
EP  - 601-610
PB  - VIA MEDICA
SN  - 18975593
KW  - QRS duration
KW  - QTc interval
KW  - chest pain
N2  - Background: While prolongation of QRS duration and QTc interval during acute myocardial infarction (AMI) has been reported in animals, limited data is available for these readily available electrocardiography (ECG) markers in humans. Methods: Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected AMI in a prospective diagnostic multicentre study were prospectively assessed, Digital 12-lead ECGs were recorded at presentation. QRS duration and QTc interval were automatically calculated in a blinded fashion. Final diagnosis was adjudicated by two independent cardiologists. The prognostic endpoint was all-cause mortality during 24 months of follow-up. Results: Among 4042 patients, AMI was the final diagnosis in 19% of patients. Median QRS duration and median QTc interval were significantly greater in patients with AMI compared to those with other final diagnoses (98 ms (IQR 88-108] vs. 94 ms [IQR 86-102] and 436 ms [IQR 414-462] vs. 425 ms [IQR 407-445], p < 0.001 for both comparisons). The diagnostic value of both ECG signatures however was only modest (AUC 0.56 and 0.60). Cumulative mortality rates after 2 years were 15.9% vs. 5.6% in patients with a QRS > 120 ms compared to a QRS duration <= 120 ms (p < 0.001), and 11.4% vs. 4.3% in patients with a QTc > 440 ms compared to a QRS duration <= 440 ms (p < 0.001). After adjustment for age and important ECG and clinical parameters, the QTc interval but not QRS duration remained an independent predictor of mortality. Conclusions: Prolongation of QRS duration > 120 ms and QTc interval > 440 ms predict mortality in patients with suspected AMI, but do not add diagnostic value.
ER  -

CUPA, J., I. STREBEL, P. BADERTSCHER, R. ABACHERLI, R. TWERENBOLD, L. SCHUMACHER, J. BOEDDINGHAUS, T. NESTELBERGER, P. MAECHLER, N. KOZHUHAROV, M.R. GIMENEZ, K. WILDI, J.D. de LAVALLAZ, Z. SABTI, L. SAZGARY, C. PUELACHER, D. MUELLER, C. BIANCI, O. MIRO, C. FUENZALIDA, S. CALDERON, F.J. MARTIN-SANCHEZ, S.L. IGLESIAS, B. MORAWIEE, D. KAWECKR, Jiří PAŘENICA, D.I. KELLER, N. GEIGY, S. OSSWALD, C. MUELLER a T. REICHLIN. Diagnostic and prognostic value of QRS duration and QTc interval in patients with suspected myocardial infarction. \textit{CARDIOLOGY JOURNAL}. GDANSK: VIA MEDICA, 2018, roč.~25, č.~5, s.~601-610. ISSN~1897-5593. Dostupné z: https://dx.doi.org/10.5603/CJ.a2018.0033.

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