An electrocardiography score predicts heart failure hospitalization or death beyond that of cardiovascular magnetic resonance imaging

• Published in: Scientific reports Vol. 12; no. 1; pp. 18364 - 9
• Main Authors: Maanja, Maren, Schlegel, Todd T., Fröjdh, Fredrika, Niklasson, Louise, Wieslander, Björn, Bacharova, Ljuba, Schelbert, Erik B., Ugander, Martin
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.11.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308/409; 692/4019; Congestive heart failure; EKG; Electrocardiography; Electrocardiography - methods; Female; Heart Failure; Heart rate; Hospitalization; Humanities and Social Sciences; Humans; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging, Cine; Male; Medical prognosis; Middle Aged; multidisciplinary; Predictive Value of Tests; Prognosis; Risk Assessment; Risk Factors; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-22501-9

The electrocardiogram (ECG) and cardiovascular magnetic resonance imaging (CMR) provide powerful prognostic information. The aim was to determine their relative prognostic value. Patients (n = 783) undergoing CMR and 12-lead ECG with a QRS duration < 120 ms were included. Prognosis scores for one-year event-free survival from hospitalization for heart failure or death were derived using continuous ECG or CMR measures, and multivariable logistic regression, and compared. Patients (median [interquartile range] age 55 [43–64] years, 44% female) had 155 events during 5.7 [4.4–6.6] years. The ECG prognosis score included (1) frontal plane QRS-T angle, and (2) heart rate corrected QT duration (QTc) (log-rank 55). The CMR prognosis score included (1) global longitudinal strain, and (2) extracellular volume fraction (log-rank 85). The combination of positive scores for both ECG and CMR yielded the highest prognostic value (log-rank 105). Multivariable analysis showed an association with outcomes for both the ECG prognosis score (log-rank 8.4, hazard ratio [95% confidence interval] 1.29 [1.09–1.54]) and the CMR prognosis score (log-rank 47, hazard ratio 1.90 [1.58–2.28]). An ECG prognosis score predicted outcomes independently of CMR. Combining the results of ECG and CMR using both prognosis scores improved the overall prognostic performance.