Clinical impact of left and right axis deviations with narrow QRS complex on 3-year outcomes in a hospital-based population in Japan

Abstract While the prognostic impact of QRS axis deviation has been assessed, it has never been investigated in patients without conduction block. Thus, we evaluated the prognostic impact of QRS-axis deviation in patients without conduction block. We retrospectively analyzed 3353 patients who had un...

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Autores principales:	Yuta Seko, Takao Kato, Yuhei Yamaji, Yoshisumi Haruna, Eisaku Nakane, Tetsuya Haruna, Moriaki Inoko
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dd06fde9c0194b43a1aabd79a312361d
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spelling	oai:doaj.org-article:dd06fde9c0194b43a1aabd79a312361d2021-12-02T14:53:43ZClinical impact of left and right axis deviations with narrow QRS complex on 3-year outcomes in a hospital-based population in Japan10.1038/s41598-021-88259-82045-2322https://doaj.org/article/dd06fde9c0194b43a1aabd79a312361d2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88259-8https://doaj.org/toc/2045-2322Abstract While the prognostic impact of QRS axis deviation has been assessed, it has never been investigated in patients without conduction block. Thus, we evaluated the prognostic impact of QRS-axis deviation in patients without conduction block. We retrospectively analyzed 3353 patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in a hospital-based population, after excluding patients with a QRS duration of ≥ 110 ms, pacemaker placement, and an QRS-axis − 90° to − 180° (northwest axis). The study population was categorized into three groups depending on the mean frontal plane QRS axis as follows: patients with left axis deviation (N = 171), those with right axis deviation (N = 94), and those with normal axis (N = 3088). The primary outcome was a composite of all-cause death and major adverse cardiovascular events. The cumulative 3-year incidence of the primary outcome measure was significantly higher in the left axis deviation group (26.4% in the left axis deviation, 22.7% in the right axis deviation, and 18.4% in the normal axis groups, log-rank P = 0.004). After adjusting for confounders, the excess risk of primary outcome measure remained significant in the left axis deviation group (hazard ratio [HR] 1.44; 95% confidence interval [CI] 1.07–1.95; P = 0.02), while the excess risk of primary outcome measure was not significant in the right axis deviation group (HR 1.22; 95% CI 0.76–1.96; P = 0.41). Left axis deviation was associated with a higher risk of a composite of all-cause death and major adverse cardiovascular events in hospital-based patients without conduction block in Japan.Yuta SekoTakao KatoYuhei YamajiYoshisumi HarunaEisaku NakaneTetsuya HarunaMoriaki InokoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yuta Seko Takao Kato Yuhei Yamaji Yoshisumi Haruna Eisaku Nakane Tetsuya Haruna Moriaki Inoko Clinical impact of left and right axis deviations with narrow QRS complex on 3-year outcomes in a hospital-based population in Japan
description	Abstract While the prognostic impact of QRS axis deviation has been assessed, it has never been investigated in patients without conduction block. Thus, we evaluated the prognostic impact of QRS-axis deviation in patients without conduction block. We retrospectively analyzed 3353 patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in a hospital-based population, after excluding patients with a QRS duration of ≥ 110 ms, pacemaker placement, and an QRS-axis − 90° to − 180° (northwest axis). The study population was categorized into three groups depending on the mean frontal plane QRS axis as follows: patients with left axis deviation (N = 171), those with right axis deviation (N = 94), and those with normal axis (N = 3088). The primary outcome was a composite of all-cause death and major adverse cardiovascular events. The cumulative 3-year incidence of the primary outcome measure was significantly higher in the left axis deviation group (26.4% in the left axis deviation, 22.7% in the right axis deviation, and 18.4% in the normal axis groups, log-rank P = 0.004). After adjusting for confounders, the excess risk of primary outcome measure remained significant in the left axis deviation group (hazard ratio [HR] 1.44; 95% confidence interval [CI] 1.07–1.95; P = 0.02), while the excess risk of primary outcome measure was not significant in the right axis deviation group (HR 1.22; 95% CI 0.76–1.96; P = 0.41). Left axis deviation was associated with a higher risk of a composite of all-cause death and major adverse cardiovascular events in hospital-based patients without conduction block in Japan.
format	article
author	Yuta Seko Takao Kato Yuhei Yamaji Yoshisumi Haruna Eisaku Nakane Tetsuya Haruna Moriaki Inoko
author_facet	Yuta Seko Takao Kato Yuhei Yamaji Yoshisumi Haruna Eisaku Nakane Tetsuya Haruna Moriaki Inoko
author_sort	Yuta Seko
title	Clinical impact of left and right axis deviations with narrow QRS complex on 3-year outcomes in a hospital-based population in Japan
title_short	Clinical impact of left and right axis deviations with narrow QRS complex on 3-year outcomes in a hospital-based population in Japan
title_full	Clinical impact of left and right axis deviations with narrow QRS complex on 3-year outcomes in a hospital-based population in Japan
title_fullStr	Clinical impact of left and right axis deviations with narrow QRS complex on 3-year outcomes in a hospital-based population in Japan
title_full_unstemmed	Clinical impact of left and right axis deviations with narrow QRS complex on 3-year outcomes in a hospital-based population in Japan
title_sort	clinical impact of left and right axis deviations with narrow qrs complex on 3-year outcomes in a hospital-based population in japan
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/dd06fde9c0194b43a1aabd79a312361d
work_keys_str_mv	AT yutaseko clinicalimpactofleftandrightaxisdeviationswithnarrowqrscomplexon3yearoutcomesinahospitalbasedpopulationinjapan AT takaokato clinicalimpactofleftandrightaxisdeviationswithnarrowqrscomplexon3yearoutcomesinahospitalbasedpopulationinjapan AT yuheiyamaji clinicalimpactofleftandrightaxisdeviationswithnarrowqrscomplexon3yearoutcomesinahospitalbasedpopulationinjapan AT yoshisumiharuna clinicalimpactofleftandrightaxisdeviationswithnarrowqrscomplexon3yearoutcomesinahospitalbasedpopulationinjapan AT eisakunakane clinicalimpactofleftandrightaxisdeviationswithnarrowqrscomplexon3yearoutcomesinahospitalbasedpopulationinjapan AT tetsuyaharuna clinicalimpactofleftandrightaxisdeviationswithnarrowqrscomplexon3yearoutcomesinahospitalbasedpopulationinjapan AT moriakiinoko clinicalimpactofleftandrightaxisdeviationswithnarrowqrscomplexon3yearoutcomesinahospitalbasedpopulationinjapan
_version_	1718389417439133696

Clinical impact of left and right axis deviations with narrow QRS complex on 3-year outcomes in a hospital-based population in Japan

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