Scientific Reports (Nov 2022)

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

  • Maren Maanja,
  • Todd T. Schlegel,
  • Fredrika Fröjdh,
  • Louise Niklasson,
  • Björn Wieslander,
  • Ljuba Bacharova,
  • Erik B. Schelbert,
  • Martin Ugander

DOI
https://doi.org/10.1038/s41598-022-22501-9
Journal volume & issue
Vol. 12, no. 1
pp. 1 – 9

Abstract

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Abstract 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.