What question did this study set out to answer?

To investigate the prognostic impact of native QRS duration in heart failure with mildly reduced ejection fraction (HFmrEF).

February 6, 2026

Native QRS duration and outcomes in heart failure with mildly reduced ejection fraction: results from a large-scaled registry

Q: What does this research mean for the field?

Patients with QRS duration ≥120 ms have a 57.4% higher risk of heart failure-related rehospitalization compared to those with QRS duration <120 ms. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Resultado clave

Patients with QRS duration ≥120 ms had a 57.4% higher risk of heart failure-related rehospitalization compared to those with QRS duration <120 ms (HR 1.574).

Puntos clave

To investigate the prognostic impact of native QRS duration in heart failure with mildly reduced ejection fraction (HFmrEF).
Retrospective inclusion of consecutive patients with HFmrEF from 2016 to 2022.
Comparison of patients with QRS duration ≥120 ms and <120 ms.
Risk stratification based on left and right bundle branch block (LBBB vs. RBBB).
Primary endpoint: all-cause mortality at 30 months.
1,627 patients included; median QRS duration was 90 ms with 15% having QRS ≥120 ms.
No significant increase in long-term all-cause mortality with prolonged QRS duration (35.1% vs. 28.7%; p = 0.057).
Higher risk of HF-related rehospitalization in patients with QRS ≥120 ms (18.2% vs. 11.9%; p = 0.008).
QRS duration ≥120 ms remained a risk factor for rehospitalization after multivariable adjustment (HR 1.413, p = 0.049).

PICO estructurado

Does prolonged QRS duration (≥120 ms) increase the risk of mortality or heart failure rehospitalization in patients with HFmrEF?

Población

1,627 consecutive patients with heart failure with mildly reduced ejection fraction (HFmrEF)

Intervención

Prolonged QRS duration (≥120 ms)

Comparador

Normal QRS duration (<120 ms)

Resultado

All-cause mortality at 30 monthshard clinical

In patients with HFmrEF, a prolonged QRS duration (≥120 ms) serves as an independent predictor of heart failure rehospitalization, though it does not significantly impact long-term all-cause mortality.

Resultado numérico

Tasa de eventos absoluta: 0% vs 0%

Resumen

Abstract Objective The study investigates the prognostic impact of the native QRS duration in patients with heart failure with mildly reduced ejection fraction (HFmrEF). Background The prognostic impact of QRS duration in HFmrEF has poorly been investigated. Methods Consecutive patients with HFmrEF were retrospectively included at one institution from 2016 to 2022. Patients with QRS duration ≥120 ms were compared to patients with QRS duration 120 ms, further risk stratification was performed comparing patients with left and right bundle branch block (LBBB vs. RBBB). The primary endpoint was all-cause mortality at 30 months, secondary endpoints comprised amongst others the risk of HF-related rehospitalization. Results In total, 1,627 patients with HFmrEF were included with a median QRS duration of 90 ms (QRS duration ≥120 ms: 15%). Although the risk of long-term all-cause mortality was not affected by a prolonged QRS duration (35.1% vs. 28.7%; p = 0.057; HR = 1.254; 95% CI 0.993 – 1.583), patients with QRS duration ≥120 ms had a higher risk of HF-related rehospitalization (18.2% vs. 11.9%; p = 0.008; HR = 1.574; 95% CI 1.124 – 2.204). A QRS duration ≥120 ms was associated with long-term HF- related rehospitalization even after multivariable adjustment (HR 1.413, 95% CI 1.002 – 1.992, p = 0.049). Finally, the risks of long-term all-cause mortality and HF-related rehospitalization did not differ among patients with LBBB and RBBB. Conclusion A prolonged QRS duration is independently associated with a higher risk of HF-related rehospitalization in HFmrEF, but not long-term all-cause mortality.

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