Clinical Outcomes of Complete Left Bundle Branch Block According to Strict or Conventional Definition Criteria in Patients with Normal Left Ventricular Function
Journal
ACTA CARDIOLOGICA SINICA
Journal Volume
36
Journal Issue
4
Pages
335-342
Date Issued
2020-07
Author(s)
Abstract
Background: Complete left bundle branch block (cLBBB) is associated with poor outcomes in patients with heart failure (HF) but appears to have minimal effects on cardiovascular (CV) mortality in relatively healthy adults. New criteria to define strict cLBBB have been proposed. Objectives: The aim of this study was to stratify the potential risk of cLBBB according to conventional or strict criteria in patients with normal ejection fraction (EF). Methods: Patients with cLBBB from 2010 to 2013 who underwent baseline echocardiography within 1 year and had a left ventricular ejection fraction (LVEF) > 50% were enrolled. A control group of patients without intraventricular conduction abnormalities matched for age and sex was included. Primary outcomes including CV mortality, HF admission, EF reduction of 40%, and total mortality were compared. Results: A total of 137 patients with cLBBB were included, of whom 118 had strict cLBBB. The mean age was 72 - 15 years and 56.2% were men. With a median follow-up of 4.3 years, normal LVEF patients with cLBBB but without a history of atrial fibrillation had a significantly higher risk of CV mortality (p < 0.001), EF reduction to 40% (p < 0.001), and admission for HF (p < 0.001). A similar risk of CV events was noted for the patients with conventional and strict cLBBB. Conclusions: In patients with normal EF and without a history of atrial fibrillation, the presence of cLBBB led to a greater risk of CV mortality, HF admission and EF reduction to < 40%. Strict cLBBB carries a similar risk of CV events to conventional cLBBB.
Subjects
Ejection fraction; Left bundle branch block; Outcome; CONGESTIVE-HEART-FAILURE; ATRIAL-FIBRILLATION; ITALIAN NETWORK; PROGNOSIS; POPULATION; CARDIOLOGY; MORTALITY; SOCIETY
SDGs
Other Subjects
acute coronary syndrome; aged; Article; atrial fibrillation; cardiac patient; cardiovascular mortality; cardiovascular risk; cerebrovascular accident; clinical outcome; congestive heart failure; controlled study; echocardiography; electrocardiogram; female; follow up; heart ejection fraction; heart failure; heart left bundle branch block; heart left ventricle ejection fraction; heart left ventricle function; heart ventricle conduction; hospitalization; human; hypertension; lung function; major clinical study; male; outcome assessment; proportional hazards model; QRS interval; quality of life; retrospective study
Publisher
TAIWAN SOC CARDIOLOGY
Type
journal article