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Poor R-wave progression as a predictor of sudden cardiac death in the general population and subjects with coronary artery disease |
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| Author: | Schröder, Linda C.1; Holkeri, Arttu2; Eranti, Antti3; |
| Organizations: |
1Division of Internal Medicine, Department of Internal Medicine and Rehabilitation, Helsinki University Hospital and University of Helsinki, Helsinki, Finland 2Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland 3Heart Center, Central Hospital of North Karelia, Joensuu, Finland
4Research Unit of Internal Medicine, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
5Center for Machine Vision and Signal Analysis (CMVS), University of Oulu, Oulu, Finland 6Finnish Institute for Health and Welfare, Helsinki, Finland 7Division of Cardiology, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland |
| Format: | article |
| Version: | published version |
| Access: | open |
| Online Access: | PDF Full Text (PDF, 1.3 MB) |
| Persistent link: | http://urn.fi/urn:nbn:fi-fe2023060552465 |
| Language: | English |
| Published: |
Elsevier,
2022
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| Publish Date: | 2023-06-05 |
| Description: |
AbstractBackground: Poor R-wave progression (PRWP) is a common clinical finding on the standard 12-lead electrocardiogram (ECG), but its prognostic significance is unclear. Objective: The purpose of this study was to examine the prognosis associated with PRWP in terms of sudden cardiac death (SCD), cardiac death, and all-cause mortality in general population subjects with and without coronary artery disease (CAD). Methods: Data and 12-lead ECGs were collected from a Finnish general population health examination survey conducted during 1978–1980 with follow-up until 2011. The study population consisted of 6854 subjects. Main end points were SCD, cardiac death, and all-cause mortality. PRWP was defined as R-wave amplitude ≤ 0.3 mV in lead V₃ and R-wave amplitude in lead V₂ ≤ R-wave amplitude in lead V₃. Results: PRWP occurred in 213 subjects (3.1%). During the follow-up period of 24.3 ± 10.4 years, 3723 subjects (54.3%) died. PRWP was associated with older age, higher prevalence of heart failure and CAD, and β-blocker medication. In multivariate analyses, PRWP was associated with SCD (hazard ratio [HR] 2.13; 95% confidence interval [CI] 1.34–3.39), cardiac death (HR 1.75; 95% CI 1.35–2.15), and all-cause mortality (HR 1.29; 95% CI 1.08–1.54). In the subgroup with CAD, PRWP had a stronger association with cardiac mortality (HR 1.71; 95% CI 1.19–2.46) than in the subgroup without CAD, while the association with SCD was significant only in the subgroup with CAD (HR 2.62; 95% CI 1.38–4.98). Conclusions: PRWP was associated with adverse prognosis in the general population and with SCD in subjects with CAD. see all
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| Series: |
Heart rhythm |
| ISSN: | 1547-5271 |
| ISSN-E: | 1556-3871 |
| ISSN-L: | 1547-5271 |
| Volume: | 19 |
| Issue: | 6 |
| Pages: | 952 - 959 |
| DOI: | 10.1016/j.hrthm.2022.02.010 |
| OADOI: | https://oadoi.org/10.1016/j.hrthm.2022.02.010 |
| Type of Publication: |
A1 Journal article – refereed |
| Field of Science: |
3121 General medicine, internal medicine and other clinical medicine |
| Subjects: | |
| Funding: |
This work was supported by the Orion Research Foundation (to Dr Holkeri) and the Sigrid Jusélius Foundation (to Drs Aro and Holkeri). Funding sources were not involved in the study design; in the data collection, analysis, or interpretation; in the writing of the report; or in the decision to submit the article for publication. |
| Copyright information: |
© 2022 Heart Rhythm Society. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/). |
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https://creativecommons.org/licenses/by/4.0/ |