Electrocardiographic Predictors of Heart Failure With Reduced Versus Preserved Ejection Fraction: The Multi‐Ethnic Study of Atherosclerosis

• DOI: 10.1161/jaha.117.006023
• Publication Date: 2017-05-26T00:20:10Z
• Authors: Wesley T. O'Neal; Matylda Mazur; Alain G. Bertoni; David A. Bluemke; Mouaz H. Al‐Mallah; Joao A. C. Lima; Dalane Kitzman; Elsayed Z. Soliman
• Keywords: Male; Time Factors; electrocardiography; heart failure; Risk Assessment; Electrocardiography; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; Risk Factors; Diseases of the circulatory (Cardiovascular) system; Humans; Original Research; Aged; Proportional Hazards Models; Aged, 80 and over; Heart Failure; Chi-Square Distribution; Incidence; Arrhythmias, Cardiac; Stroke Volume; Middle Aged; Prognosis; United States; 3. Good health; RC666-701; Multivariate Analysis; epidemiology; Female

Several markers detected on the routine 12-lead ECG are associated with future heart failure events. We examined whether these able to separate risk of reduced ejection fraction (HFrEF) from preserved (HFpEF).We analyzed data 6664 participants (53% female; mean age 62±10 years) MESA (Multi-Ethnic Study Atherosclerosis) who were free cardiovascular disease at baseline (2000-2002). A competing risks analysis was used compare association several predictors HFrEF and HFpEF during a median follow-up 12.1 years. total 127 117 events follow-up. In multivariable adjusted model, prolonged QRS duration, delayed intrinsicoid deflection, left-axis deviation, right-axis QT interval, abnormal QRS-T axis, left ventricular hypertrophy, ST/T-wave abnormalities, bundle-branch block HFrEF. contrast, higher resting rate, P-wave axis HFpEF. The versus significantly differently for deflection (hazard ratio: 4.90 [95% confidence interval (CI), 2.77-8.68] 0.94 CI, 0.29-2.97]; comparison P=0.013), 2.39 1.55-3.68] 0.52 0.23-1.19]; P<0.001), abnormalities 2.47 1.69-3.62] 1.13 0.72-1.77]; P=0.0093).Markers repolarization activation distinguish between These findings suggest role in personalized assessment subtypes.