Author:
Seko Yuta,Kato Takao,Yamaji Yuhei,Haruna Yoshisumi,Nakane Eisaku,Haruna Tetsuya,Inoko Moriaki
Abstract
AbstractWhile the prognostic impact of QRS axis deviation has been assessed, it has never been investigated in patients without conduction block. Thus, we evaluated the prognostic impact of QRS-axis deviation in patients without conduction block. We retrospectively analyzed 3353 patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in a hospital-based population, after excluding patients with a QRS duration of ≥ 110 ms, pacemaker placement, and an QRS-axis − 90° to − 180° (northwest axis). The study population was categorized into three groups depending on the mean frontal plane QRS axis as follows: patients with left axis deviation (N = 171), those with right axis deviation (N = 94), and those with normal axis (N = 3088). The primary outcome was a composite of all-cause death and major adverse cardiovascular events. The cumulative 3-year incidence of the primary outcome measure was significantly higher in the left axis deviation group (26.4% in the left axis deviation, 22.7% in the right axis deviation, and 18.4% in the normal axis groups, log-rank P = 0.004). After adjusting for confounders, the excess risk of primary outcome measure remained significant in the left axis deviation group (hazard ratio [HR] 1.44; 95% confidence interval [CI] 1.07–1.95; P = 0.02), while the excess risk of primary outcome measure was not significant in the right axis deviation group (HR 1.22; 95% CI 0.76–1.96; P = 0.41). Left axis deviation was associated with a higher risk of a composite of all-cause death and major adverse cardiovascular events in hospital-based patients without conduction block in Japan.
Publisher
Springer Science and Business Media LLC
Reference25 articles.
1. Basile, G. et al. Electrocardiographic changes in centenarians: A study on 42 subjects and comparison with the literature. Gerontology 58, 216–220. https://doi.org/10.1159/000330801 (2012).
2. Vicent, L. & Martinez-Selles, M. Electrocardiogeriatrics: ECG in advanced age. J. Electrocardiol. 50, 698–700. https://doi.org/10.1016/j.jelectrocard.2017.06.003 (2017).
3. Rissanen, V., Raunio, H. & Lampainen, E. Mean electrical QRS axis on the frontal plane in electrocardiograms of middle-aged and elderly hospital patients. Ann. Clin. Res. 8, 359–367 (1976).
4. Fragola, P. V. et al. Limitations of the electrocardiographic diagnosis of left ventricular hypertrophy: The influence of left anterior hemiblock and right bundle branch block. Int. J. Cardiol. 34, 41–48. https://doi.org/10.1016/0167-5273(92)90080-m (1992).
5. Elizari, M. V., Acunzo, R. S. & Ferreiro, M. Hemiblocks revisited. Circulation 115, 1154–1163. https://doi.org/10.1161/CIRCULATIONAHA.106.637389 (2007).
Cited by
6 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献