ECG Measurements Provide Additional Prediction Method for Death in Patients with High-Risk Heart Failure

In this secondary analysis of the VICTORIA trial, researchers sought to determine if electrocardiographic (ECG) measurements predict death in patients with chronic heart failure with reduced ejection fraction (HFrEF), a condition in which the heart is unable to pump out blood effectively.

Recently published in the European Journal of Heart Failure, this study included 4,880 patients from the VICTORIA trial with a baseline 12-lead ECG, a non-invasive test used to measure the electrical signals in the heart. The researchers explored the relationship between ECG measurements and death, in addition to the trial’s primary composite endpoint of cardiovascular death and heart failure hospitalization. They also examined selected interactions between ECG parameters, patient characteristics, and death.

The researchers found that routine ECG measurements (higher heart rate and prolonged QRS duration) predict death in high-risk HFrEF patients. Furthermore, their findings demonstrated that women with contiguous pathologic Q waves, indicating damage to the heart muscle, have an increased risk of death compared to men. 

“This study demonstrates how a simple, low-cost and easily available test can be used to predict death in high-risk HFrEF patients,” says CVC faculty member and co-author Dr. Roopinder Sandhu. “Importantly, we found a sex difference in a particular ECG parameter that could help us to identify women who may benefit from early and aggressive treatment. Future studies will determine if this approach may reduce the risk of death in women.”

This research was conducted by the VICTORIA study group, and CVC co-authors include Dr. Haran Yogasundaram (Cardiology Fellow/Trainee), Yinggan Zheng, Eric Ly, Dr. Justin Ezekowitz, Tracy Temple, Dr. Cindy Westerhout, Dr. Paul Armstrong, and Dr. Roopinder Sandhu. The CVC ECG Core Laboratory played a pivotal role in this study through their key contributions and expert analysis.