The Clinical Study Of The Assessment Role Of Electrocardiographic QRS Duration In Patients With Heart Failure

Objective：We aimed to to investigate the association of QRS duration with heart failure,and to explore the correlation of electrocardiographic QRS duration with cardiacstructure and function in patients with heart failure, ultimately to determine thediagnostic and prognostic value of electrocardiographic QRS duration for heartfailure.Methods:473patients diagnosed with heart failure and100healthy individuals who wereadmitted in China Japan Union Hospital of Jilin University from2012.6to2012.10were retrospectively analyzed. Data including age, gender, medical history,electrocardiographic QRS duration in admission, echocardiographic left ventricularejection fraction (LVEF), left ventricular fractional shortening (LVFS), left atrum(LA), left ventricular end diastolic diameter (LVEDd) were recorded.473heart failurepatients were stratified based on QRS duration, patient with QRS＜100ms were forthe first group (271patients,57.3%),100-119ms for the second (108patients,22.8%), and≥120ms for the third (94patients,19.9%). We applied t test fo thedifference of QRS duration, LA, LVEDd between patients and healthy individuals,One-way ANOVA for comparing the difference of QRS duration, LA, LVEDd inthree subgroups, and Pearson correlation analysis for the relativity between QRSduration and echocardiographic results.Reasults:Comparison of QRS duration, LA, LVEDd between patients with HF and heathyindividuals. Difference of QRSd in HF patients (101.45±23.82)ms and in normalgroup (94.95±11.18)ms was statistically significant (P=0.000). Difference of LA inHF patients (39.7262±8.09)mm and in normal group (31.066±4.42)mm wasstatistically significant (P=0.000). Difference of LVEDd in HF patients (51.88±21.39)mm and in normal group (43.54±5.76)mm was statistically significant(P=0.000). According to the results of One-way ANOVA, there are statisticalsignificances in QRS duration, LVEF, LVFS, LA, LVEDd among3subgroups (P＜0.05). Pearson correlation analysis for the relativity between QRS duration andechocardiographic results shows QRS duration is associated negatively with LVEF,positively with LA and LVEDd significantly.Conclusion：1. The presence of QRS prolongation in patients with HF was further confirmed,showing the significant diagnositic value of QRS for HF patiens.2. LVEF descends as electrocardiographic QRSd in HF patients gradually increases,indicating the clinical value of QRS for assessment of systolic dysfuncition.3. LA and LVEDd enlargement worsen as electrocardiographic QRSd in HFpatients gradually increases, indicating the clinical value of QRS for judging theremodeling of heart failure.