Accelerated cardiovascular ageing in first-degree atrioventricular block

Background: Role of PR prolongation in cardiovascular ageing was unclear. Objective: To investigate the relations of PR prolongation with arterial stiffness and left ventricular ejection fraction (LVEF) in patients with CAD or risk equivalent. Methods: We studied 347 high-risk cardiovascular outpatients with stable CAD or risk equivalent (mean age 66 ± 11 yrs; male 64%). Heart-Ankle Pulse Wave Velocity (PWV) was assessed. Impaired LVEF as determined from transthoracic echocardiography (subgroup n=150) was defined as <35%. Results: PR prolongation >200ms was present in 43 patients (12%). Patients with PR prolongation had significantly higher mean PWV (1144±142 cms-1 versus 1090±144 cms-1, P=0.021) and lower mean LVEF (48±13% versus 54±12%, P=0.011). Impaired LVEF<35% was more common among patients with PR prolongation >200ms (P=0.002). Adjusted for potential confounders, PR prolongation >200ms was independently associated with increased PWV (B=+46.30 cms-1 [95%CI: 7.46 to 85.14], P=0.020) and impaired LVEF (OR=12.6 [95%CI: 1.3 to 125.7], P=0.031). Adjustment for QRS duration attenuated association of PR prolongation with LVEF (OR=8.7 [95%CI: 0.6 to 119.3], P=0.104) but not arterial stiffness. Conclusions: PR prolongation is associated with accelerated cardiovascular ageing among high-risk cardiovascular patients.