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. 2016 Apr;38(2):44.
doi: 10.1007/s11357-016-9907-0. Epub 2016 Apr 2.

ECG low QRS voltage and wide QRS complex predictive of centenarian 360-day mortality

Jan Szewieczek  1 , Zbigniew Gąsior  2 , Jan Duława  3 , Tomasz Francuz  4 , Katarzyna Legierska  3 , Agnieszka Batko-Szwaczka  5 , Beata Hornik  6 , Magdalena Janusz-Jenczeń  6 , Iwona Włodarczyk  6 , Krzysztof Wilczyński  5
Affiliations

ECG low QRS voltage and wide QRS complex predictive of centenarian 360-day mortality

Jan Szewieczek et al. Age (Dordr). 2016 Apr.

Abstract

We examined the electrocardiographic (ECG) findings of centenarians and associated them with >360-day survival. Physical and functional assessment, resting electrocardiogram and laboratory tests were performed on 86 study participants 101.9 ± 1.2 years old (mean ± SD) (70 women, 16 men) and followed for at least 360 days. Centenarian ECGs were assessed for left ventricular hypertrophy (LVH) according to the Romhilt-Estes score, Sokolow-Lyon criteria and Cornell voltage criteria which were positive for 12.8, 6.98, and 10.5 % of participants, respectively. Fifty-two study participants (60 %) survived ≥360 days. Multivariate logistic regression analysis revealed a negative relationship between 360-day survival and the following: R II <0.45 mV adjusted for CRP (odds ratio (OR) = 0.108, 95 % confidence interval (CI) = 0.034-0.341, P < .001), R aVF < 0.35 mV adjusted for CRP (OR = 0.151, 95 % CI = 0.039-0.584, P < .006), Sokolow-Lyon voltage <1.45 mV adjusted for CRP (OR = 0.178, 95 % CI = 0.064-0.492, P = .001), QRS ≥90 ms adjusted for CRP (OR = 0.375, 95 % CI = 0.144-0.975, P = .044), and Romhilt-Estes score ≥5 points adjusted for sex and Barthel Index (OR = 0.459, 95 % CI = 0.212-0.993, P = .048) in single variable ECG models. QRS voltage correlated positively with systolic and pulse pressure, serum vitamin B12 level, sodium, calcium, phosphorous, TIMP-1, and eGFR. QRS voltage correlated negatively with BMI, WHR, serum leptin, IL-6, TNF-α, and PAI-1 levels. QRS complex duration correlated positively with CRP; QTc correlated positively with TNF-α. Results suggest that Romhilt-Estes LVH criteria scores ≥5 points, low ECG QRS voltages (Sokolow-Lyon voltage <1.45 mV), and QRS complexes ≥90 ms are predictive of centenarian 360-day mortality.

Keywords: Centenarians; ECG; Left ventricular hypertrophy; Low QRS voltage.

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Figures

Fig. 1
Fig. 1
Kaplan–Meier survival probability of centenarians classified according to a amplitude of R wave in lead II ≥0.45 mV versus lower values, b amplitude of R wave in lead II ≥0.35 mV versus lower values, c Sokolow–Lyon voltage ≥1.45 mV versus lower values, and d QRS complex duration <90 ms versus higher values
See this image and copyright information in PMC

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