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274 QRS DURATION AND Q-TC INTERVAL DO NOT CORRELATE WITH SERUM MARKER OF MYOCARDIAL FIBROSIS IN PATIENTS WITH ADVANCED SYSTOLIC HEART FAILURE.
  1. A. Sadhu1,
  2. K Phisitkul1,
  3. L. Puga1,
  4. J. Simoni1,
  5. M. Pierce1,
  6. C. Roongsritiong1
  1. 1Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX

Abstract

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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