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

Nikolaidou, T., Pellicori, P. , Zhang, J., Kazmi, S., Goode, K. M., Cleland, J. G. and Clark, A. L. (2018) Prevalence, predictors, and prognostic implications of PR interval prolongation in patients with heart failure. Clinical Research in Cardiology, 107(2), pp. 108-119. (doi: 10.1007/s00392-017-1162-6) (PMID:28917011) (PMCID:PMC5790844)

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Abstract

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.

Item Type:Articles
Additional Information:This article/paper/report presents independent research funded by the National Institute for Health Research (NIHR).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John and Pellicori, Dr Pierpaolo
Authors: Nikolaidou, T., Pellicori, P., Zhang, J., Kazmi, S., Goode, K. M., Cleland, J. G., and Clark, A. L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Clinical Research in Cardiology
Publisher:Springer
ISSN:1861-0684
ISSN (Online):1861-0692
Published Online:15 September 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Clinical Research in Cardiology 2017
Publisher Policy:Reproduced under a Creative Commons license

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