Abstract
To evaluate the prognostic impact of QRS width in patients with low-flow/low-gradient aortic stenosis (LF/LGAS). 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 in two groups according to baseline QRS duration (cutoff: QRS≥ 130ms). Follow-up data, including electrocardiographic evolution and overall mortality were analyzed. 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≥ 130ms. Among operated patients, there was no significant change in QRS duration between baseline and latest follow-up (126±26 vs. 131±25ms; p=0.82). In addition, wider QRS was a strong independent predictor of overall mortality [HR=2.20; CI, 1.15–4.24; p=0.027]. Significant intra-ventricular 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.
Published Version
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