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Prevalence, predictors, and prognostic implications of PR interval prolongation in patients with heart failure

Nikolaidou, Theodora; Pellicori, Pierpaolo; Zhang, Jufen; Kazmi, Syed; Goode, Kevin M.; Cleland, John G.; Clark, Andrew L.

Authors

Theodora Nikolaidou

Pierpaolo Pellicori

Jufen Zhang

Syed Kazmi

John G. Cleland

Andrew L. Clark

Abstract

© 2017 The Author(s) Aims: 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.

Journal Article Type Article
Publication Date 2018-02
Journal Clinical research in cardiology
Print ISSN 1861-0684
Electronic ISSN 1861-0692
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 107
Issue 2
Pages 108-119
Institution Citation Nikolaidou, T., Pellicori, P., Zhang, J., Kazmi, S., Goode, K. M., Cleland, J. G., & Clark, A. L. (2018). Prevalence, predictors, and prognostic implications of PR interval prolongation in patients with heart failure. Clinical Research in Cardiology, 107(2), 108-119. https://doi.org/10.1007/s00392-017-1162-6
DOI https://doi.org/10.1007/s00392-017-1162-6
Keywords First-degree heart block, Heart failure, PR interval
Publisher URL https://link.springer.com/article/10.1007%2Fs00392-017-1162-6
Additional Information Copy of article first published in: Clinical research in cardiology, 2017.

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Copyright Statement
© The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)




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