Purpose QRS duration is currently used to select patients with advanced systolic heart failure (HF) for device therapy. Q-Tc prolongation has long been associated with increased risk of ventricular arrhythmias. We hypothesized that the degree of fibrosis within the myocardium may influence QRS duration and Q-Tc interval in patients with advanced systolic HF.
Methods Thirty-six patients with systolic HF and EF < 35% were enrolled. The 12-lead ECGs were reviewed for QRS duration and Q-Tc determination. In general, computerized values were used unless they were significantly different from the manually measured values. Serum marker of fibrosis, carboxy-terminal of the procollagen type I (PICP), was determined by a commercial ELISA kit (Takara Inc.). Data are presented as mean ± standard deviation. Correlation between QRS duration and Q-Tc interval to PICP levels and selected echocardiographic (ECHO) parameters of the left ventricle were assessed. A p value < .05 was considered statistically significant.
Results The mean left ventricular ejection fraction (EF), QRS duration, and Q-Tc interval were 23.0 ± 5.4%, 125.8 ± 33.9 milliseconds, 487.6 ± 42.0, respectively. Mean PICP level was 997.4 ± 455.1 ng/mL.
Conclusions In this small study of patients with advanced systolic HF, the degree of myocardial fibrosis as determined by serum levels of PICP did not correlate with QRS duration or Q-Tc interval. Q-Tc, on the other hand, significantly correlated with EF.
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