E1271JACC March 12, 2013Volume 61, Issue 10
Pericardial/Myocardial Disease/Pulmonary Hypertension
resTing hearT raTe is an imporTanT deTerminanT of morTaliTy in paTienTs wiTh pulmonary arTerial hyperTension due To congeniTal hearT disease
Poster ContributionsPoster Sessions, Expo NorthSunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Pulmonary Hypertension: Right Ventricle / Congenital Heart DiseaseAbstract Category: 27. Pulmonary HypertensionPresentation Number: 1208-156
Authors: Mark J. Schuuring, Annelieke van Riel, Jeroen Vis, Marielle Duffels, Rolf Berger, Elke Hoendermis, Arie Van Dijk, Hubert Vliegen, Barbara Mulder, Berto Bouma, Academic Medical Center, Amsterdam, The Netherlands
Background: Pulmonary arterial hypertension due to congenital heart disease (CHD-PAH) remains a devastating disease. We aimed to determine early electrocardiographic (ECG) markers of mortality in this subset of patients.
methods: In this multicenter study we prospectively evaluated 75 consecutive adults (age 46 ± 13 years, 43% male) with CHD-PAH referred for advanced medical therapy. Heart rate (HR), PR interval, QRS duration and QT dispersion were derived from ECGs, which were performed routinely.
results: During a median follow up of 5.6 (range 0.2 to 7.5) years 19 patients died. Before treatment initiation (HR per 10-beats/min increase 1.58, 95% CI 1.15 to 2.17) a higher HR at rest was a determinant of mortality (p <0.01), see Table. Patients with a HR above 85 beats/min had a three times higher risk of mortality as compared to patients with a HR below 85 beats/min at rest (p = 0.03)
conclusion: ECG-derived heart rate at rest is an important marker of prognosis and could be involved in clinical decision making.
Table Determinants of mortality in 75 consecutive patients with CHD-PAH
Hazard ratio 95% CI p
ECG at baseline
Heart rate (per 10-beats / min increase) 1.58 1.15 - 2.17 < 0.01
PR interval (per 10 ms) 1.00 0.99 - 1.01 0.92
QRS duration (per 10 ms) 0.91 0.76 - 1.09 0.29
QT dispersion (per 10-ms increase) 1.07 0.91 - 1.25 0.43
