To determine the relationship between QRS duration and Left ventricular structural and functional changes in the hypertensive population.Design and Method:
The Korean Registry of Target Organ Damages in Hypertension (KorHR) is a multi-centered prospective study which enrolled1318 essential hypertension patients without any cardiovascular diseases from March 2013. Among 1318 subjects enrolled in the registry, This study analyzed 378 patients whose Electrocardiogram (ECG) and echocardiographic data were available. QRS duration was evaluated as categorical variables (QRS 110 ms and QRS < 110 ms) and a continuous variable.Results:
Patients with prolonged QRSduration (QRS 110 ms)were more likely to be male (82.1% vs. 59.4%, p = 0.025)and current smokers (42.9 vs. % vs. 18.3% p = 0.004). Duration of hypertension and cardiovascular risk factors (Dyslipidemia, diabetes mellitus, systolic and diastolic blood pressure and eGFR) were not significantly different between the two groups. Diastolic LV internal dimension (LVIDd)(median 48.5[IQR:46–52] vs. median 51[IQR:49.8–53.2], p = 0.015), diastolic Interventricular Septal thickness (IVSd)(median 31[IQR:28–34] vs. median 33[IQR:29–34.5], p = 0.001), diastolic LV posterior wall dimension (LVPWd)(median 9[IQR:8–10] vs. median 10[IQR:9–11.3], p = 0.008) and LV mass index (median 9[IQR:8–10] vs. median 10[IQR:9–11.3], p = 0.008) were significantly greater in the prolonged QRS group. QRS duration was positively correlated to LVIDd (r = 0.224, p < 0.001), IVSd (r = 0.224, p < 0.001), LVPWd (r = 0.261, p < 0.001) and LV mass index (r = 0.23 p < 0.001).Conclusions:
QRS duration showed significant positive correlations with LV dimensions and LV mass index. This result suggests that QRS duration might be an early marker of structural change of LV in the hypertensive patients without cardiovascular complications.