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J-curve relationship between corrected QT interval and mortality in acute heart failure patients
  • Date2021-02-23 17:23
  • Update2021-02-23 17:23
  • CountersignatureDivision of Research Planning
  • Tel043-719-8033

Korean J Intern Med, 2020.35, 1371-1384, DOI: https://doi.org/10.3904/kjim.2019.030


J-curve relationship between corrected QT interval and mortality in acute heart failure patients

Chan Soon Park, Hyun-Jai Cho; Eue-Keun Choi; Sang Eun Lee; Min-Seok Kim; Jae-Joong Kim; Jin-Oh Choi; Eun-Seok Jeon; Kyung-Kuk Hwang; Shung Chull Chae; Sang Hong Baek; Seok-Min Kang; Byungsu Yoo; Dong-Ju Choi; Youngkeun Ahn; Kye-Hoon Kim; Myeong-Chan Cho; Byung-Hee Oh; Hae-Young Lee


Abstract

    Background/aims: This study investigated the prognostic power of corrected QT (QTc) interval in patients with acute heart failure (AHF) according to sex.
    Methods: We analyzed multicenter Korean Acute Heart Failure registry with patients with AHF admitted from 2011 to 2014. Among them, we analyzed 4,990 patients who were followed up to 5 years. Regarding QTc interval based on 12 lead electrocardiogram, patients were classified into quartiles according to sex.
    Results: During follow-up with median 43.7 months, 2,243 (44.9%) patients died. The relationship between corrected QT interval and all-cause mortality followed a J-curve relationship. In Kaplan-Meier analysis, both sex had lowest mortality in the second QTc quartile. There were significant prognostic differences between the second and the fourth quartiles in male (log-rank p = 0.002), but not in female (log-rank p = 0.338). After adjusting covariates, the third (hazard ratio [HR], 1.185; 95% confidence interval [CI], 1.001 to 1.404; p = 0.049) and the fourth (HR, 1.404; 95% CI, 1.091 to 1.535; p = 0.003) quartiles demonstrated increased risk of mortality compared to the second quartile in male. In female, however, there was no significant difference across quartiles. QTc interval was associated with 5-year all-cause mortality in J-shape with nadir of 440 to 450 ms in male and 470 to 480 ms in female.
    Conclusion: QTc interval was an independent predictor of overall death in male, but its significance decreased in female. The relationship between QTc interval and all-cause mortality was J-shaped in both sex.



  • 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
  • This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.


This public work may be used under the terms of the public interest source This public work may be used under the terms of the public interest source
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