title: Prevalence and clinical impact of QRS duration in patients with low-flow/low-gradient aortic stenosis due to left ventricular systolic dysfunction.
abstract: OBJECTIVE
  To evaluate the prognostic impact of QRS width in patients with low-flow/low-gradient aortic stenosis (LF/LGAS).
  
  
  RESULTS
  Among 88 consecutive patients referred to our institution for LF/LGAS from September 1994 to March 2007, baseline demographic, clinical, echocardiographic, and electrocardiographic data were collected. This population was divided into two groups according to baseline QRS duration (cut-off QRS ≥130 ms). Follow-up data, including electrocardiographic evolution and overall mortality, were analysed. The mean follow-up duration was 3.1 (2.2-6.2) years. In the whole group, 67 patients underwent surgical aortic valve replacement. Forty-nine patients (56%) had a QRS duration ≥130 ms. Among operated patients, there was no significant change in QRS duration between baseline and latest follow-up (126 ± 26 ms vs. 131 ± 25 ms; P = 0.82). In addition, wider QRS was a strong independent predictor of overall mortality (hazard ratio 2.20, 95% confidence interval 1.15-4.24; P = 0.027).
  
  
  CONCLUSIONS
  Significant intraventricular conduction disturbances are common in patients with LF/LGAS and do not recover after aortic valve replacement. QRS duration is strongly associated with mortality in this selected population.
authors.affiliation: Department of Cardiology, Henri Mondor Hospital (Assistance Publique-Hôpitaux de Paris), Creteil, France.
authors.forename: Frédéric A
authors.initials: FA
authors.lastname: Sebag
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lellouche
authors.forename: Najia
authors.initials: N
authors.lastname: Chaachoui
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Dubois-Rande
authors.forename: Pascal
authors.initials: P
authors.lastname: Gueret
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Monin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000209:etiology / Q000503:physiopathology*; D001145:Arrhythmias, Cardiac / Q000453:epidemiology* / Q000209:etiology; D017023:Coronary Angiography; D025401:Echocardiography, Stress; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology*
keywords: Bundle branch block; Intraventricular conduction; Low-flow/low-gradient aortic stenosis