{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T06:21:26Z","timestamp":1782973286825,"version":"3.54.5"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T00:00:00Z","timestamp":1685145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is ongoing controversy regarding the prognostic value of PR prolongation among individuals free of cardiovascular diseases. It is necessary to risk\u2010stratify this population according to other electrocardiographic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study is based on the Third National Health and Nutrition Examination Survey. Cox proportional hazard models were constructed and Kaplan\u2013Meier method was used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 6188 participants (58.1\u2009\u00b1\u200913.1\u2009years; 55% women) were included. The median frontal QRS axis of the entire study population was 37\u00b0 (IQR: 11\u201360\u00b0). PR prolongation was present in 7.6% of the participants, of whom 61.2% had QRS axis \u226437\u00b0. In a multivariable\u2010adjusted model, mortality risk was highest in the group with concomitant prolonged PR interval and QRS axis \u226437\u00b0 (hazard ratio [HR]: 1.20; 95% confidence interval [CI]: 1.04\u20131.39). In models with similar adjustment where population were reclassified depending on PR prolongation and QRS axis, prolonged PR interval and QRS axis \u226437\u00b0 was still associated with increased risk of mortality (HR: 1.18; 95% CI: 1.03\u20131.36) compared with normal PR interval.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>QRS axis is an important factor for risk stratification in population with PR prolongation. The extent to which this population with PR prolongation and QRS axis \u226437\u00b0 is at higher risk of death compared with the population without PR prolongation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.13066","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T15:28:22Z","timestamp":1685201302000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Value of frontal <scp>QRS<\/scp> axis for risk stratification of individuals with prolonged <scp>PR<\/scp> interval"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6872-5671","authenticated-orcid":false,"given":"Xiaodi","family":"Cao","sequence":"first","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9238-4088","authenticated-orcid":false,"given":"Zhe","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6185-3187","authenticated-orcid":false,"given":"Zhang","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Cardiology The First Affiliated Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3450-9457","authenticated-orcid":false,"given":"Chuanchuan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, School of Public Health Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7763-5368","authenticated-orcid":false,"given":"Linsheng","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Cardiology The Second Affiliated Hospital of Nantong University  Nantong China"},{"name":"Nantong school of Clinical medicine Kangda College of Nanjing Medical University  Nantong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht176"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur393"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(88)90237-9"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2003.11.002"},{"key":"e_1_2_11_6_1","article-title":"P wave parameters and indices: A critical appraisal of clinical utility, challenges, and future research\u2014A consensus document endorsed by the International Society of Electrocardiology and the International Society for Holter and Noninvasive Electrocardio","volume":"15","author":"Chen L. 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