Nikolaidou_et_al_2018.pdf (1.17 MB)
Prevalence, predictors and prognostic implications of PR interval prolongation in patients with heart failure
journal contribution
posted on 2023-07-26, 14:10 authored by Theodora Nikolaidou, Pierpaolo Pellicori, Jufen Zhang, Syed Kazmi, Kevin M. Goode, John G. F. Cleland, Andrew L. ClarkAims:
To determine the prevalence, incidence, predictors and prognostic implications of PR interval prolongation in patients referred with suspected heart failure.
Methods and Results:
Consecutive patients referred with suspected heart failure were prospectively enrolled. After excluding patients with implantable cardiac devices and atrial fibrillation, 1420 patients with heart failure and reduced ejection fraction (HeFREF) [age: median 71 (interquartile range IQR: 63-78) years; men: 71%; NT-ProBNP: 1319 (583-3378) ng/L], 1094 with heart failure and normal ejection fraction (HeFNEF) [age: 76 (70-82) years; men: 47%; NT-ProBNP: 547 (321-1171) ng/L], and 1150 without heart failure [age: 68 (60-75) years; men: 51%; NT-ProBNP: 86 (46-140) ng/L] were included.
The prevalence of first degree heart block [heart-rate corrected PR interval (PRc) >200 ms] was higher in patients with heart failure (21% HeFREF, 20% HeFNEF, 9% without heart failure). In patients with HeFREF or HeFNEF, longer baseline PRc was associated with greater age, male sex, and longer QRS duration and, in those with HeFREF, treatment with amiodarone or digoxin.
Patients with heart failure in the longest PRc quartile had worse survival compared to shorter PRc quartiles but PRc was not independently associated with survival in multivariable analysis. For patients without heart failure, shorter baseline PRc was independently associated with worse survival.
Conclusion:
PRc prolongation is common in patients with HeFREF or HeFNEF and associated with worse survival, although not an independent predictor of outcome. The results of clinical trials investigating the therapeutic potential of shortening the PR interval by pacing are awaited.
History
Refereed
- Yes
Volume
107Issue number
2Page range
108-119Publication title
Clinical Research in CardiologyISSN
1861-0692External DOI
Publisher
SpringerFile version
- Published version
Language
- eng
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Legacy posted date
2017-10-12Legacy creation date
2017-10-05Legacy Faculty/School/Department
ARCHIVED Faculty of Medical Science (until September 2018)Usage metrics
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