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Nigerian Journal of Clinical Practice

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Prognostic Significance Of QT Interval Prolongation In Adult Nigerians With Chronic Heart Failure.

PM Kolo, OG Opadijo, ABO Omotoso, IA Katibi, MO Balogun, MA Araoye

Abstract




Prognostic survival studies for heart-rate corrected QT interval in patients with
chronic heart failure are few; although these patients are known to have a high risk of sudden cardiac death. This study was aimed at determining the mortality risk associated with prolonged QTc in Nigerians with heart failure. Ninety-six consecutive patientswith heart failurewere recruitedwith 90 age and sexmatched controls.All the subjects had a 12-lead electrocardiogramat a paper speed of 25mm/sec and a rhythm strip (lead II) at 50mm/sec.The latterwas used to calculate theQTc using the Bazett\'s formula. Left ventricular
systolic and diastolic functions were assessed using 2D guided M-mode and Doppler echocardiogram respectively.Theywere followed-up for sixmonths. Ninety-one patients and 90 controls completed the study. Five patients were lost to follow-up. The
mean age (51.9±16 years) of the patientswas similar to that of the controls (50.3±15) (P= 0.475).Twenty-eight (30.8%) patients died after 6months of follow-up against none of the controls.The mean QTc was significantly longer in the non-survivors (0.494±0.027) than in the survivors (0.462±0.035) (P = 0.0001). The percentage mortality in patients with prolonged QTc against those with normal QTc was 41% and 14% respectively (P =
0.001). In the stepwise regression analysis, QTc was an independent predictor of mortality (R = 0.412, R = 0.17, P= 0.001). QTc prolongation is a predictor of mortality in CHF and may be an important adjunct in risk stratification of patientswith heart failure.

Keywords: Chronic Heart Failure, QTc Prolongation, Mortality

Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 336-341



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