Abstract
BackgroundProlonged electrocardiogram (ECG) QRS duration has been associated with increased cardiovascular risk. It is unclear whether the main predictor of cardiovascular risk, the Framingham risk score also predicts short-term changes in ECG QRS duration. Our aim is to determine whether baseline Framingham risk score is associated with baseline or changes in QRS duration.MethodsA retrospective cross-sectional analysis was performed using observational data obtained from two hundred two participants. Framingham risk score was calculated using an online risk calculator. QRS duration was obtained using a 10 s trace from a Welch Allyn PC-based 12-lead ECG system.ResultsAverage follow-up duration was 3.3 ± 1.1 years. Mean QRS change was 1.8 ± 11.4 ms. Specifically, among two hundred two participants, there are 104 subjects with a greater QRS duration at follow-up, while 98 subjects had the same or a shorter follow-up QRS duration. Baseline Framingham risk score did not significantly predict an increase in QRSd with an odds ratio of 1.04 (P = 0.230). Regression analysis of QRS duration at baseline and Framingham risk at baseline had a weak association (R2 = 0.020; P = 0.043). The Framingham risk score at follow-up was likewise has a weak association with follow-up QRS duration (R2 = 0.045; P = 0.002).ConclusionsOur results do not demonstrate a statistically significant association between Framingham risk parameters and future QRS duration changes over longitudinal time. QRS duration had variable changes between baseline and follow-up. This might suggest that a longer period of follow-up is required to document more stable increases in QRS duration associated with ventricular pathology. A larger population study is needed to confirm our observations.
Highlights
The Framingham Heart study, since its origin in 1948, has enhanced our understanding of how cardiovascular risk factors can predict cardiovascular disease risk [1, 2]
A prolonged QRS duration has been associated with coronary artery disease (CAD) [7], congestive heart failure (CHF) [8] and increased overall
One study from the Framingham population study demonstrated that an increased QRS duration was associated with risk of development of new onset congestive heart failure that was independent of baseline adjustments of left ventricular cardiac mass [10]
Summary
The Framingham Heart study, since its origin in 1948, has enhanced our understanding of how cardiovascular risk factors can predict cardiovascular disease risk [1, 2]. There is interest in non-Framingham Heart risk parameters that may be useful, such as ECG-derived QRS duration [4, 5]. A prolonged QRS duration has been associated with coronary artery disease (CAD) [7], congestive heart failure (CHF) [8] and increased overall. One study from the Framingham population study demonstrated that an increased QRS duration was associated with risk of development of new onset congestive heart failure that was independent of baseline adjustments of left ventricular cardiac mass [10]. Prolonged electrocardiogram (ECG) QRS duration has been associated with increased cardiovascular risk. It is unclear whether the main predictor of cardiovascular risk, the Framingham risk score predicts short-term changes in ECG QRS duration. Our aim is to determine whether baseline Framingham risk score is associated with baseline or changes in QRS duration
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