Cross-sectional relations of electrocardiographic QRS duration to left ventricular dimensions: the Framingham Heart Study.
OBJECTIVE
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.
Dhingra
Ravi
R
Framingham Heart Study, Framingham, Massachusetts; Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA.
Ho Nam
Byung
B
Benjamin
Emelia J
EJ
Wang
Thomas J
TJ
Larson
Martin G
MG
D'Agostino
Ralph B
RB
Levy
Daniel
D
Vasan
Ramachandran S
RS
D000328:Adult; D000368:Aged; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000503:physiopathology; D002306:Cardiac Volume / Q000502:physiology*; D015331:Cohort Studies; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000503:physiopathology; D016014:Linear Models; D008133:Long QT Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D012815:Signal Processing, Computer-Assisted; D013223:Statistics as Topic; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000502:physiology