Objectives: The goal of this study was to assess the relations of electrocardiographic QRS duration to left ventricular(LV)measurements in individuals without heart failure(HF) or prior myocardial infarction(MI). Back...Objectives: The goal of this study was to assess the relations of electrocardiographic QRS duration to left ventricular(LV)measurements in individuals without heart failure(HF) or prior myocardial infarction(MI). Background: Increased electrocardiographic QRS duration(< 120 ms) is a marker of ventricular dyssynchrony. Methods: We evaluated the relations of maximal electrocardiographic QRS duration to echocardiographic LV dimensions in 4,534 Framingham Heart study participants(mean age 54 years, 57% women) without prior HF or MI. QRS duration was analyzed as a continuous variable and as categories(< 100, 100 to 119, and< 120 ms). Results: In linear regression models, LV mass, end- diastolic dimension, and septal and posterior wall thicknesses were positively related to log- QRS duration, whereas fractional shortening(FS) was inversely related(p< 0.001). There was a significant trend for increasing LV mass and dimensions, and decreasing FS across categories of QRS duration(p< 0.001). Left bundle branch block was associated with higher LV mass and lower FS compared with a normal QRS duration(p< 0.001). Conclusions: In our community- based sample of individuals free of HF and MI, increasing electrocardiographic QRS duration was positively related to LV mass and dimensions, and inversely associated with LV FS. Additional investigations are warranted to elucidate the mechanisms underlying the observed associations.展开更多
Background: The association between heart failure in parents and the prevalence of left ventricular systolic dysfunction and the risk of heart failure in their offspring has not been investigated in a community-based ...Background: The association between heart failure in parents and the prevalence of left ventricular systolic dysfunction and the risk of heart failure in their offspring has not been investigated in a community-based setting. Methods: We examined the cross-sectional association of heart failure in parents with the prevalence of left ventricular systolic dysfunction, as well as left ventricular mass, internal dimensions, and wall thickness, in 1497 participants of the Framingham Offspring Study(mean age, 57 years; 819 women) who underwent routine echocardiography. We also investigated prospectively whether heart failure in parents increased the risk of heart failure in 2214 offspring(mean age, 44 years; 1150 women). Results: As compared with the 1039 participants whose parents did not have heart failure, the 458 participants in the cross-sectional cohort who had at least one parent with heart failure were more likely to have increased left ventricular mass(17.0 percent vs. 26.9 percent), left ventricular internal dimensions(18.6 percent vs. 23.4 percent), and left ventricular systolic dysfunction(3.1 percent vs. 5.7 percent); the multivariable-adjusted odds ratios were 1.35(95 percent confidence interval, 0.99 to 1.84), 1.29(95 percent confidence interval, 0.96 to 1.72), and 2.37(95 percent confidence interval, 1.22 to 4.61), respectively. In the longitudinal cohort, heart failure developed in 90 offspring during follow-up(mean length of follow-up, 20 years). The age-and sex-adjusted 10-year incidence rates of heart failure were 2.72 percent among offspring with a parent with heart failure, as compared with 1.62 percent among those without a parent with heart failure. This increase in risk persisted after multivariable adjustment(hazard ratio, 1.70; 95 percent confidence interval, 1.11 to 2.60). Conclusions: Heart failure in parents is associated with an increased prevalence of left ventricular systolic dysfunction cross-sectionally and an elevated risk of heart failure longitudinally. Our data emphasize the contribution of familial factors to the heart-failure burden in the community.展开更多
文摘Objectives: The goal of this study was to assess the relations of electrocardiographic QRS duration to left ventricular(LV)measurements in individuals without heart failure(HF) or prior myocardial infarction(MI). Background: Increased electrocardiographic QRS duration(< 120 ms) is a marker of ventricular dyssynchrony. Methods: We evaluated the relations of maximal electrocardiographic QRS duration to echocardiographic LV dimensions in 4,534 Framingham Heart study participants(mean age 54 years, 57% women) without prior HF or MI. QRS duration was analyzed as a continuous variable and as categories(< 100, 100 to 119, and< 120 ms). Results: In linear regression models, LV mass, end- diastolic dimension, and septal and posterior wall thicknesses were positively related to log- QRS duration, whereas fractional shortening(FS) was inversely related(p< 0.001). There was a significant trend for increasing LV mass and dimensions, and decreasing FS across categories of QRS duration(p< 0.001). Left bundle branch block was associated with higher LV mass and lower FS compared with a normal QRS duration(p< 0.001). Conclusions: In our community- based sample of individuals free of HF and MI, increasing electrocardiographic QRS duration was positively related to LV mass and dimensions, and inversely associated with LV FS. Additional investigations are warranted to elucidate the mechanisms underlying the observed associations.
文摘Background: The association between heart failure in parents and the prevalence of left ventricular systolic dysfunction and the risk of heart failure in their offspring has not been investigated in a community-based setting. Methods: We examined the cross-sectional association of heart failure in parents with the prevalence of left ventricular systolic dysfunction, as well as left ventricular mass, internal dimensions, and wall thickness, in 1497 participants of the Framingham Offspring Study(mean age, 57 years; 819 women) who underwent routine echocardiography. We also investigated prospectively whether heart failure in parents increased the risk of heart failure in 2214 offspring(mean age, 44 years; 1150 women). Results: As compared with the 1039 participants whose parents did not have heart failure, the 458 participants in the cross-sectional cohort who had at least one parent with heart failure were more likely to have increased left ventricular mass(17.0 percent vs. 26.9 percent), left ventricular internal dimensions(18.6 percent vs. 23.4 percent), and left ventricular systolic dysfunction(3.1 percent vs. 5.7 percent); the multivariable-adjusted odds ratios were 1.35(95 percent confidence interval, 0.99 to 1.84), 1.29(95 percent confidence interval, 0.96 to 1.72), and 2.37(95 percent confidence interval, 1.22 to 4.61), respectively. In the longitudinal cohort, heart failure developed in 90 offspring during follow-up(mean length of follow-up, 20 years). The age-and sex-adjusted 10-year incidence rates of heart failure were 2.72 percent among offspring with a parent with heart failure, as compared with 1.62 percent among those without a parent with heart failure. This increase in risk persisted after multivariable adjustment(hazard ratio, 1.70; 95 percent confidence interval, 1.11 to 2.60). Conclusions: Heart failure in parents is associated with an increased prevalence of left ventricular systolic dysfunction cross-sectionally and an elevated risk of heart failure longitudinally. Our data emphasize the contribution of familial factors to the heart-failure burden in the community.
