IMPORTANCE OF QRS COMPLEX DURATION IN THE CLINICAL COURSE AND OUTCOMES OF CARDIOVASCULAR DISEASES
Keywords:
QRS complex duration, prolongation of the QRS complex, shortening of the QRS complex, cardiovascular diseases
Abstract
QRS complex plays an important| role in heart work. Changes of its duration by shortening or prolonga-tion cause serious difficulties in electrophysiology and biomechanics of the heart. Recent publications| concerning changes of QRS complex duration in different cardiovascular diseases are given. The electrophysiology, biochemistry and biomechanical implementation of QRS complex and factors that influence its duration are discussed. The causes and mechanisms of changes of QRS complex duration during cardiovascular diseases are considered. It is emphasized that QRS complex duration influences not only clinical status, but also prognosis of the patients with cardiovascular diseases.
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References
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24. Cumulative effect of complete left bundle-branch block and chronic atrial fibrillation on 1-year mortality and hospitalization in patients with congestive heart failure / Baldasseronia S., De Biaseb L., Frescoc C. et al. // European Heart Journal. – 2002. – Vol. 23(21). – P. 1692 – 1698.
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26. Early repolarization electrocardiography pattern with unexplained syncope during training in a young black African non-elite athlete: An accidental finding? / Bonny A., Ditah I., Amara W. et al. // Cardiolo-gy Journal. – 2009. – Vol. 16. – № 3. – Р. 259 – 263.
27. Early repolarization in the inferolateral leads: a new syndrome associated with sudden cardiac death / Haissaguerre M., Sacher F., Derval N., et al. // J Interv Card Electrophysiol. – 2007. – Vol. 18. – № 3. – P. 281.
28. Electrocardiographic QRS Duration and the Risk of Congestive Heart Failure. The 28. El-Sh. Nabil, P. Ronald, H. IV Herman. Role of Pharmacotherapy in Cardiac Ion Channelopathies // Current Vascular Pharmacology. – 2009. Vol. 7. – № 3. – P. 358 – 366(9).
29. Factors influencing the one-year mortality of dilated cardiomyopathy/ Unverferth D.V., Magorien R.D., Moeschberger M.L. et al. // Am J Cardiol. – 1984. – Vol. 54. – P. 147 – 152.
30. Farouque H.M., Sanders P., Young G.D. Intravenous magnesium sulfate for acute termination of sus-tained monomorphic ventricular tachycardia associated with coronary artery disease // Am J Cardiol. – 2000. Vol. 86. – P. 1270 – 1272.
31. Features of an exceptionally narrow QRS data set / Childers R., Holmes A., Kocherginsky M. et al. / Journal of Electrocardiology. – 2008. – Vol. 41. – P. 501–507.
32. Framingham Heart Study / Dhingra R., Pencina M. J., Wang T.J et al. // Hypertension. – 2006. – Vol. 47. – P. 861 – 867.
33. Frank G. Yanowitz, M.D. The Alan E. Lindsay ECG Learning Center. – 2006. http://library.med.utah.edu/kw/ecg
34. Frequency of inter- and intraventricular dyssynchrony in patients with heart failure according to QRS width / Emkanjoo1 Z., Esmaeilzadeh M., Hadi1 M. et al // Europace. – 2007. – Vol. 9(12). – P. 1171 – 1176.
35. Grigioni F., Piovaccari G., Boriani G. Prolonged QRS and QTc interval and mortality // Heart. – 2007. – Vol 93(9). – P. 1093 – 1097.
36. Gussak I., George S. ECG Phenomena of the Early Ventricular Repolarization in the 21 Century // Indian Pacing Electrophysiol. J. – 2008. – Vol. 8(3). – P. 149 – 157.
37. Incremental changes in QRS duration in serial ECGs over time identify high risk elderly patients with heart failure / Shamim W., Yousufuddin M., Cicoria M., et al. // Heart. – 2002. – Vol. 88(1). – P. 47–51.
38. Is a narrow and tall QRS complex an ECG marker for sudden death? / Wolpert C., Veltmann C., Gussak I. et al. // Heart Rhythm. – 2008. – Vol. 5. – P. 1339 –1345.
39. Jeevanantham V., Daubert J.P., Zareba W. Cardiac resynchronization therapy in heart failure patients: an update // Cardiol J. – 2009. – Vol. 16(3). – P. 197 – 209.
40. Kashani A., Barold S. Significance of QRS Complex Duration in Patients With Heart Failure // J Am Coll Cardiol. – 2005. – Vol. 46. – P. 2183 – 2192.
41. Katz A. M. Physiology of the heart. – 2005. – 644 p.
42. Left ventricular dyssynchrony evaluated by echocardiography in chronic heart failure patients with nor-mal and wide QRS duration / Sun Y.G., Shen W.F., Zhang F.R. et al. // Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases]. – 2008. – Vol. 36(1). – P. 44 – 48.
43. Long-term prognostic significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy / Ol-shausen K.V., Stienen U., Schwarz F. et al. // Am J Cardiol. – 1988. – Vol. 61. – P. 146 – 151.
44. Management of atrial fibrillation in patients with heart failure / Neuberger H.-R., Mewis C., J. van Veld-huisen D. et al. // European Heart Journal. – 2007. – Vol. 28(21). – P. 2568 – 2577.
45. Moss A.J. Do “narrow and tall” QRS complexes “stand tall” and have arrhythmogenic implications? // Heart Rhythm. – 2008. – Vol. 5. – № 9. – P. 1346 – 1346.
46. Narrow and tall QRS complex: a novel ECG marker for sudden cardiac death? / Wolpert C., Veltmann C., Antzelevitch C. et al. // Heart Rhythm. – 2008. – Vol. 5. – P. 1339 – 1345.
47. Olshansky B. Wide QRS, Narrow QRS .What’s the Difference? // J Am Coll Cardiol. – 2005. – Vol. 46. – P. 317 – 319.
48. Prevalence of mechanical dyssynchrony in heart failure patients with different QRS durations / Haghjoo M., Bagherzadeh A., Fazelifar A.F. et al. // Pacing Clin Electrophysiol. – 2007. – Vol. 30(5). – P. 616 – 622.
49. Primary myocardial disease part Iclinical features / Dye C.L., Rosenbaum D., Lowe J.C. et al. // Ann In-tern Med. – 1963. – Vol. 58. – P. 426 – 441.
50. Prolonged QRS Duration and Severity of Mitral Regurgitation are Unfavorable Prognostic Markers of Heart Failure in Patients With Nonischemic Dilated Cardiomyopathy / Amiya E., Tanabe K., Ikari Y. et al. // Circulation Journal. – 2006. – Vol. 70. – P. 57– 62.
51. QRS and QTc interval prolongation in the prediction of long-term mortality of patients with acute desta-bilised heart failure / Breidthardt T., Christ M., Matti M., et al. // Heart. – 2007. – Vol. 93. – P. 1093 – 1097.
52. QRS duration: a simple marker for predicting cardiac mortality in ICD patients with heart failure / Bode-Schnurbus L., Böcker D., Block M. et al. // Heart. – 2003. – Vol. 89. – Р. 1157 – 1162.
53. Relationship between QRS duration and left ventricular dyssynchrony in patients with end-stage heart failure / Bleeker G.B., Schalij M.J., Molhoek S.G. et al. // J Cardiovasc Electrophysiol. – 2004. – Vol. 15. – P. 544 – 549.
54. Relationship between QRS duration and prognosis in non-ST-segment elevation acute coronary syn-drome / Javier J.-C., Ignacio C.G., Francisco M. et al. // Int J Cardiol. – 2008. – Vol. 126. – Р. 196 – 203.
55. Relationship between QRS complex notch and ventricular dyssynchrony in patients with heart failure and prolonged QRS duration / Fazelifar A.F., Bonakdar H.R., Alizadeh K. et al. // Cardiol J. – 2008. – Vol 15(4). – Р. 351 – 356.
56. Risk Stratification of Patients With Acute Anterior Myocardial Infarction and Right Bundle-Branch Block. Importance of QRS Duration and Early ST-Segment Resolution After Fibrinolytic Therapy / Wong C.-K., Gao W., Stewart R. et al. // Circulation. – 2006. – Vol. 114. – P.783 – 789.
57. Rogers J. Cardiovascular Physiology // Physiology. – 1999. – Vol. 10. –Р. 1 – 4.
58. Significance of QRS morphology in determining the prevalence of mechanical dyssynchrony in heart failure patients eligible for cardiac resynchronization: particular focus on patients with right bundle branch block with and without coexistent left-sided conduction defects / Haghjoo M., Bagherzadeh A., Farahani M.M. et al. // Europace. – 2008. – Vol. 10(5). – P. 566 – 571.
59. Sudden Cardiac Arrest Associated with Early Repolarization / Haïssaguerre M., Derval N., Sacher F. et al. // N Engl J Med. – 2008 Vol. 358. – P. 2016 – 2023.
60. The Textbook of Emergency Cardiovascular Care and CPR/ Field J. M., O'Connor R., Bresler M. et al. – 2008. – 640 p.
61. Varma N. Left ventricular conduction delays and relation to QRS configuration in patients with left ven-tricular dysfunction // Am J Cardiol. – 2009. – Vol. 103(11). – P. 1578 – 1585.
62. Wang N. C., Maggioni A. P., Marvin A. Clinical Implications of QRS Duration in Patients Hospitalized With Worsening Heart Failure and Reduced Left Ventricular Ejection Fraction // JAMA. – 2008. – Vol. 299(22). – P. 2656 – 2666.
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2. Бобров В.А., Тхор Н.В. Нарушение внутрижелудочковой проводимости при инфаркте миокарда: электрокардиографический аспект // Український кардіол. журнал. – 2005. – № 3. – С. 121 – 126.
3. Бондарук О.С., Пономарева О.В. Злокачественная гиперкальциемия: механизмы возникновения и принципы терапии (Обзор литературы и результаты собственных исследований) // Онкология. – 2005. – Т. 7 . – № 3. – С. 219-229.
4. Дядык А.И., Багрий А.Э, Колесник Н.А. Сердечные гликозиды. – Донецк, 2000. – 300 с.
5. Дядык А.И. Фибрилляция предсердий. – Донецк, КП «Регион». – 2001. – 390 с.
6. Кушаковский М.С., Балябин А.А., Успенская М.К. Хронические идиопатические блокады ножек пучка Гиса: болезни Ленегра и Лева // Кардиология. – 1991. – № 8. – С. 99 – 103.
7. Кушаковский М.С. Аритмии сердца. СПб.: «Гиппократ», 1992. – 464 с.
8. Мальцев В. И., Казимирко В. К.. Гомеостаз натрия и калия в организме, его нарушения. // Здоро-вье Украины. 2004. – № 89. www.health-ua.com
9. Морман Д., Хеллер Л. Физиология сердечно-сосудистой системы. – СПб.: Издательство «Питер», 2000. – 256 с.
10. Первичные (генетически детерминированные) заболевания проводящей системы сердца / Шуль-ман, Никулина С., Матюшин Г. и др. // Кардиология. – 2000. – № 1. – С. 89 – 92.
11. Применение амиодарона у больных с фибрилляцией предсердий / Соловьян А.Н., Романова Е.Н, Срибная О.В. и др. – 2006. www.medicusamicus.com
12. Ресинхронизация работы сердца - современный метод коррекции хронической сердечной недостаточности / Никифоров В.С., Диденко М.В., Хубулава Г.Г. и др. // Российский кардиологический журнал. – 2005. – № 4. – С. 87– 93.
13. Ройтберг Г.Е., Струтынский А.В. Внутренние болезни. Сердечно-сосудистая система. – М.: Би-ном-пресс, 2007. – 856 с.
14. A mechanism for immediate reduction in mitral regurgitation after cardiac resynchronization therapy Insights from mechanical activation strain mapping/ Kanzaki H., Bazaz R., Schwartzman D. et al. // J. Am. Coll. Cardiol. – 2004. – Vol. 44(8). – P. 1619 – 1625.
15. Antzelevitch C. Heterogeneity and cardiac arrhythmias: an overview// Heart Rhythm. – 2007. – Vol. 4. – P. 964 – 972.
16. Antzelevitch C. Brugada syndrome // PACE. – 2006. – Vol. 29. – P. 1130–1159.
17. Arcangelo V. P., Peterson A.M. Pharmacotherapeutics for advanced practice. – 2005. – 959 р.
18. Boineau J.P. The early repolarization variant — an ECG enigma with both QRS and J-STT anomalies // J Electrocardiol. – 2007. – Vol. 40(1). – P. 3.e1 –3.e10.
19. Characteristics of recurrent ventricular fibrillation associated with inferolateral early repolarization role of drug therapy / Haissaguerre M., Sacher F., Nogami A. et al. //. J Am Coll Cardiol. – 2009. – Vol. 53. – P. 612 – 619.
20. Congestive heart failure and QRS duration establishing prognosis study/ Shenkman H.J., Pampati V., Khandelwal A.K. et al. // Chest. – 2002. – Vol. 122. – P.528 – 534.
21. Constant J. Learning electrocardiography: a complete course. – 2003. – 630 p.
22. Craig C. R., Stitzel R. E. Modern pharmacology with clinical applications. – 2003. – 824 p.
23. Cross-sectional relations of electrocardiographic QRS duration to left ventricular dimensions The Fram-ingham Heart Study / Dhingra R., B. Ho Nam, Benjamin E.J. et al. // J Am Coll Cardiol. – 2005. – Vol. 45. – P. 685 – 689.
24. Cumulative effect of complete left bundle-branch block and chronic atrial fibrillation on 1-year mortality and hospitalization in patients with congestive heart failure / Baldasseronia S., De Biaseb L., Frescoc C. et al. // European Heart Journal. – 2002. – Vol. 23(21). – P. 1692 – 1698.
25. Determinants of QRS Prolongation in a Generalized Heart Failure Population: Findings from the Con-quest Study / Shenkman H.J., McKinnon J.E., Khandelwal A.K. et al. // Circulation. – 2000. – Vol. 102(18 Suppl II).
26. Early repolarization electrocardiography pattern with unexplained syncope during training in a young black African non-elite athlete: An accidental finding? / Bonny A., Ditah I., Amara W. et al. // Cardiolo-gy Journal. – 2009. – Vol. 16. – № 3. – Р. 259 – 263.
27. Early repolarization in the inferolateral leads: a new syndrome associated with sudden cardiac death / Haissaguerre M., Sacher F., Derval N., et al. // J Interv Card Electrophysiol. – 2007. – Vol. 18. – № 3. – P. 281.
28. Electrocardiographic QRS Duration and the Risk of Congestive Heart Failure. The 28. El-Sh. Nabil, P. Ronald, H. IV Herman. Role of Pharmacotherapy in Cardiac Ion Channelopathies // Current Vascular Pharmacology. – 2009. Vol. 7. – № 3. – P. 358 – 366(9).
29. Factors influencing the one-year mortality of dilated cardiomyopathy/ Unverferth D.V., Magorien R.D., Moeschberger M.L. et al. // Am J Cardiol. – 1984. – Vol. 54. – P. 147 – 152.
30. Farouque H.M., Sanders P., Young G.D. Intravenous magnesium sulfate for acute termination of sus-tained monomorphic ventricular tachycardia associated with coronary artery disease // Am J Cardiol. – 2000. Vol. 86. – P. 1270 – 1272.
31. Features of an exceptionally narrow QRS data set / Childers R., Holmes A., Kocherginsky M. et al. / Journal of Electrocardiology. – 2008. – Vol. 41. – P. 501–507.
32. Framingham Heart Study / Dhingra R., Pencina M. J., Wang T.J et al. // Hypertension. – 2006. – Vol. 47. – P. 861 – 867.
33. Frank G. Yanowitz, M.D. The Alan E. Lindsay ECG Learning Center. – 2006. http://library.med.utah.edu/kw/ecg
34. Frequency of inter- and intraventricular dyssynchrony in patients with heart failure according to QRS width / Emkanjoo1 Z., Esmaeilzadeh M., Hadi1 M. et al // Europace. – 2007. – Vol. 9(12). – P. 1171 – 1176.
35. Grigioni F., Piovaccari G., Boriani G. Prolonged QRS and QTc interval and mortality // Heart. – 2007. – Vol 93(9). – P. 1093 – 1097.
36. Gussak I., George S. ECG Phenomena of the Early Ventricular Repolarization in the 21 Century // Indian Pacing Electrophysiol. J. – 2008. – Vol. 8(3). – P. 149 – 157.
37. Incremental changes in QRS duration in serial ECGs over time identify high risk elderly patients with heart failure / Shamim W., Yousufuddin M., Cicoria M., et al. // Heart. – 2002. – Vol. 88(1). – P. 47–51.
38. Is a narrow and tall QRS complex an ECG marker for sudden death? / Wolpert C., Veltmann C., Gussak I. et al. // Heart Rhythm. – 2008. – Vol. 5. – P. 1339 –1345.
39. Jeevanantham V., Daubert J.P., Zareba W. Cardiac resynchronization therapy in heart failure patients: an update // Cardiol J. – 2009. – Vol. 16(3). – P. 197 – 209.
40. Kashani A., Barold S. Significance of QRS Complex Duration in Patients With Heart Failure // J Am Coll Cardiol. – 2005. – Vol. 46. – P. 2183 – 2192.
41. Katz A. M. Physiology of the heart. – 2005. – 644 p.
42. Left ventricular dyssynchrony evaluated by echocardiography in chronic heart failure patients with nor-mal and wide QRS duration / Sun Y.G., Shen W.F., Zhang F.R. et al. // Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases]. – 2008. – Vol. 36(1). – P. 44 – 48.
43. Long-term prognostic significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy / Ol-shausen K.V., Stienen U., Schwarz F. et al. // Am J Cardiol. – 1988. – Vol. 61. – P. 146 – 151.
44. Management of atrial fibrillation in patients with heart failure / Neuberger H.-R., Mewis C., J. van Veld-huisen D. et al. // European Heart Journal. – 2007. – Vol. 28(21). – P. 2568 – 2577.
45. Moss A.J. Do “narrow and tall” QRS complexes “stand tall” and have arrhythmogenic implications? // Heart Rhythm. – 2008. – Vol. 5. – № 9. – P. 1346 – 1346.
46. Narrow and tall QRS complex: a novel ECG marker for sudden cardiac death? / Wolpert C., Veltmann C., Antzelevitch C. et al. // Heart Rhythm. – 2008. – Vol. 5. – P. 1339 – 1345.
47. Olshansky B. Wide QRS, Narrow QRS .What’s the Difference? // J Am Coll Cardiol. – 2005. – Vol. 46. – P. 317 – 319.
48. Prevalence of mechanical dyssynchrony in heart failure patients with different QRS durations / Haghjoo M., Bagherzadeh A., Fazelifar A.F. et al. // Pacing Clin Electrophysiol. – 2007. – Vol. 30(5). – P. 616 – 622.
49. Primary myocardial disease part Iclinical features / Dye C.L., Rosenbaum D., Lowe J.C. et al. // Ann In-tern Med. – 1963. – Vol. 58. – P. 426 – 441.
50. Prolonged QRS Duration and Severity of Mitral Regurgitation are Unfavorable Prognostic Markers of Heart Failure in Patients With Nonischemic Dilated Cardiomyopathy / Amiya E., Tanabe K., Ikari Y. et al. // Circulation Journal. – 2006. – Vol. 70. – P. 57– 62.
51. QRS and QTc interval prolongation in the prediction of long-term mortality of patients with acute desta-bilised heart failure / Breidthardt T., Christ M., Matti M., et al. // Heart. – 2007. – Vol. 93. – P. 1093 – 1097.
52. QRS duration: a simple marker for predicting cardiac mortality in ICD patients with heart failure / Bode-Schnurbus L., Böcker D., Block M. et al. // Heart. – 2003. – Vol. 89. – Р. 1157 – 1162.
53. Relationship between QRS duration and left ventricular dyssynchrony in patients with end-stage heart failure / Bleeker G.B., Schalij M.J., Molhoek S.G. et al. // J Cardiovasc Electrophysiol. – 2004. – Vol. 15. – P. 544 – 549.
54. Relationship between QRS duration and prognosis in non-ST-segment elevation acute coronary syn-drome / Javier J.-C., Ignacio C.G., Francisco M. et al. // Int J Cardiol. – 2008. – Vol. 126. – Р. 196 – 203.
55. Relationship between QRS complex notch and ventricular dyssynchrony in patients with heart failure and prolonged QRS duration / Fazelifar A.F., Bonakdar H.R., Alizadeh K. et al. // Cardiol J. – 2008. – Vol 15(4). – Р. 351 – 356.
56. Risk Stratification of Patients With Acute Anterior Myocardial Infarction and Right Bundle-Branch Block. Importance of QRS Duration and Early ST-Segment Resolution After Fibrinolytic Therapy / Wong C.-K., Gao W., Stewart R. et al. // Circulation. – 2006. – Vol. 114. – P.783 – 789.
57. Rogers J. Cardiovascular Physiology // Physiology. – 1999. – Vol. 10. –Р. 1 – 4.
58. Significance of QRS morphology in determining the prevalence of mechanical dyssynchrony in heart failure patients eligible for cardiac resynchronization: particular focus on patients with right bundle branch block with and without coexistent left-sided conduction defects / Haghjoo M., Bagherzadeh A., Farahani M.M. et al. // Europace. – 2008. – Vol. 10(5). – P. 566 – 571.
59. Sudden Cardiac Arrest Associated with Early Repolarization / Haïssaguerre M., Derval N., Sacher F. et al. // N Engl J Med. – 2008 Vol. 358. – P. 2016 – 2023.
60. The Textbook of Emergency Cardiovascular Care and CPR/ Field J. M., O'Connor R., Bresler M. et al. – 2008. – 640 p.
61. Varma N. Left ventricular conduction delays and relation to QRS configuration in patients with left ven-tricular dysfunction // Am J Cardiol. – 2009. – Vol. 103(11). – P. 1578 – 1585.
62. Wang N. C., Maggioni A. P., Marvin A. Clinical Implications of QRS Duration in Patients Hospitalized With Worsening Heart Failure and Reduced Left Ventricular Ejection Fraction // JAMA. – 2008. – Vol. 299(22). – P. 2656 – 2666.
63. Wellens H.J. Early repolarization revisited // N Engl J Med. – 2008. – Vol. 358. – P. 2063 – 2065.
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How to Cite
BurdаІ., Lysenko, N., & Iabluchanskyi, M. (1). IMPORTANCE OF QRS COMPLEX DURATION IN THE CLINICAL COURSE AND OUTCOMES OF CARDIOVASCULAR DISEASES. The Journal of V. N. Karazin Kharkiv National University, Series "Medicine", (17), 73-81. Retrieved from https://periodicals.karazin.ua/medicine/article/view/6972
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