{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:13:12Z","timestamp":1788909192267,"version":"build-2803163510"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,11,6]]},"abstract":"\n Background<\/jats:title>\n \n Several markers detected on the routine 12\u2010lead ECG are associated with future heart failure events. We examined whether these markers are able to separate the risk of heart failure with reduced ejection fraction (\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n ) from heart failure with preserved ejection fraction (\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We analyzed data of 6664 participants (53% female; mean age 62\u00b110\u00a0years) from MESA (Multi\u2010Ethnic Study of Atherosclerosis) who were free of cardiovascular disease at baseline (2000\u20132002). A competing risks analysis was used to compare the association of several baseline\n ECG<\/jats:styled-content>\n predictors with\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n and\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n detected during a median follow\u2010up of 12.1\u00a0years. A total of 127\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n and 117\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n events were detected during follow\u2010up. In a multivariable adjusted model, prolonged\n QRS<\/jats:styled-content>\n duration, delayed intrinsicoid deflection, left\u2010axis deviation, right\u2010axis deviation, prolonged\n QT<\/jats:styled-content>\n interval, abnormal\n QRS<\/jats:styled-content>\n \u2010T axis, left ventricular hypertrophy,\n ST<\/jats:styled-content>\n \/T\u2010wave abnormalities, and left bundle\u2010branch block were associated with\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n . In contrast, higher resting heart rate, abnormal P\u2010wave axis, and abnormal\n QRS<\/jats:styled-content>\n \u2010T axis were associated with\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n . The risk of\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n versus\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n was significantly differently for delayed intrinsicoid deflection (hazard ratio: 4.90 [95% confidence interval (\n CI<\/jats:styled-content>\n ), 2.77\u20138.68] versus 0.94 [95%\n CI<\/jats:styled-content>\n , 0.29\u20132.97]; comparison\n P<\/jats:italic>\n =0.013), prolonged\n QT<\/jats:styled-content>\n interval (hazard ratio: 2.39 [95%\n CI<\/jats:styled-content>\n , 1.55\u20133.68] versus 0.52 [95%\n CI<\/jats:styled-content>\n , 0.23\u20131.19]; comparison\n P<\/jats:italic>\n <0.001), and\n ST<\/jats:styled-content>\n \/T\u2010wave abnormalities (hazard ratio: 2.47 [95%\n CI<\/jats:styled-content>\n , 1.69\u20133.62] versus 1.13 [95%\n CI<\/jats:styled-content>\n , 0.72\u20131.77]; comparison\n P<\/jats:italic>\n =0.0093).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Markers of ventricular repolarization and delayed ventricular activation are able to distinguish between the future risk of\n HF<\/jats:styled-content>\n r\n EF<\/jats:styled-content>\n and\n HF<\/jats:styled-content>\n p\n EF<\/jats:styled-content>\n . These findings suggest a role for\n ECG<\/jats:styled-content>\n markers in the personalized risk assessment of heart failure subtypes.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006023","type":"journal-article","created":{"date-parts":[[2017,5,26]],"date-time":"2017-05-26T00:20:10Z","timestamp":1495758010000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":57,"title":["Electrocardiographic Predictors of Heart Failure With Reduced Versus Preserved Ejection Fraction: The Multi\u2010Ethnic Study of Atherosclerosis"],"prefix":"10.1161","volume":"6","author":[{"given":"Wesley T.","family":"O'Neal","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matylda","family":"Mazur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Wake Forest School of Medicine, Winston\u2010Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain G.","family":"Bertoni","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Wake Forest School of Medicine, Winston\u2010Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Bluemke","sequence":"additional","affiliation":[{"name":"Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouaz H.","family":"Al\u2010Mallah","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI"},{"name":"King Abdullah International Medical Research Center, King Abdul Aziz Cardiac Center, King Saud bin Abdul Aziz University for Health Sciences Ministry of National Guard, Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao A. C.","family":"Lima","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD"},{"name":"Department of Radiology, Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalane","family":"Kitzman","sequence":"additional","affiliation":[{"name":"Section\u00a0on Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston\u2010Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsayed Z.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Section\u00a0on Cardiology, Department of Internal Medicine, Wake Forest School of Medicine, Winston\u2010Salem, NC"},{"name":"Department of Epidemiology and Prevention, Epidemiological Cardiology Research Center (EPICARE), Wake Forest School of Medicine, Winston\u2010Salem, 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