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Comparison of Incidence of Left Ventricular Systolic Dysfunction Among Patients With Left Bundle Branch Block Versus Those With Normal QRS Duration.

Publication ,  Journal Article
Sze, E; Dunning, A; Loring, Z; Atwater, BD; Chiswell, K; Daubert, JP; Kisslo, JA; Mark, DB; Velazquez, EJ; Samad, Z
Published in: Am J Cardiol
December 1, 2017

We compared the incidence of left ventricular systolic dysfunction (LVSD) among patients with left bundle branch block (LBBB) to a matched cohort of patients with a narrow QRS duration <120 ms (NQRS). We hypothesized patients with preserved ejection fraction (EF) ≥50% and LBBB would have higher incidence of LVSD compared with a matched population of NQRS patients. Patients with LBBB on electrocardiogram within 30 days of a baseline echocardiogram with EF ≥50%, who had at least 1 follow-up echocardiogram ≥6 months later, were matched 1:1 on risk factors for cardiomyopathy to patients with NQRS. Incident LVSD was defined as a decline in EF to ≤45% on follow-up echocardiogram, or heart transplant, receipt of a cardiac device for LVSD (defibrillator or biventricular pacemaker), or implantation of a left ventricular assist device ≥6 months post baseline echocardiogram. Relative risk was calculated using conditional Poisson regression techniques. The final study cohort consisted of 188 patients, 94 with LBBB and 94 with NQRS. On follow-up, progression to LVSD was noted in 36% of LBBB patients and 10% of NQRS patients. The relative risk for LVSD in patients with LBBB was 3.78 (95% confidence interval = 1.98 to 7.19). In conclusion, there is a strong association between LBBB and the subsequent development of LVSD independent of common risk factors for cardiomyopathy.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

December 1, 2017

Volume

120

Issue

11

Start / End Page

1990 / 1997

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Ventricular Dysfunction, Left
  • Systole
  • Retrospective Studies
  • North Carolina
  • Middle Aged
  • Male
  • Incidence
  • Humans
  • Heart Ventricles
 

Citation

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Sze, E., Dunning, A., Loring, Z., Atwater, B. D., Chiswell, K., Daubert, J. P., … Samad, Z. (2017). Comparison of Incidence of Left Ventricular Systolic Dysfunction Among Patients With Left Bundle Branch Block Versus Those With Normal QRS Duration. Am J Cardiol, 120(11), 1990–1997. https://doi.org/10.1016/j.amjcard.2017.08.003
Sze, Edward, Allison Dunning, Zak Loring, Brett D. Atwater, Karen Chiswell, James P. Daubert, Joseph A. Kisslo, Daniel B. Mark, Eric J. Velazquez, and Zainab Samad. “Comparison of Incidence of Left Ventricular Systolic Dysfunction Among Patients With Left Bundle Branch Block Versus Those With Normal QRS Duration.Am J Cardiol 120, no. 11 (December 1, 2017): 1990–97. https://doi.org/10.1016/j.amjcard.2017.08.003.
Sze E, Dunning A, Loring Z, Atwater BD, Chiswell K, Daubert JP, et al. Comparison of Incidence of Left Ventricular Systolic Dysfunction Among Patients With Left Bundle Branch Block Versus Those With Normal QRS Duration. Am J Cardiol. 2017 Dec 1;120(11):1990–7.
Sze, Edward, et al. “Comparison of Incidence of Left Ventricular Systolic Dysfunction Among Patients With Left Bundle Branch Block Versus Those With Normal QRS Duration.Am J Cardiol, vol. 120, no. 11, Dec. 2017, pp. 1990–97. Pubmed, doi:10.1016/j.amjcard.2017.08.003.
Sze E, Dunning A, Loring Z, Atwater BD, Chiswell K, Daubert JP, Kisslo JA, Mark DB, Velazquez EJ, Samad Z. Comparison of Incidence of Left Ventricular Systolic Dysfunction Among Patients With Left Bundle Branch Block Versus Those With Normal QRS Duration. Am J Cardiol. 2017 Dec 1;120(11):1990–1997.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

December 1, 2017

Volume

120

Issue

11

Start / End Page

1990 / 1997

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Ventricular Dysfunction, Left
  • Systole
  • Retrospective Studies
  • North Carolina
  • Middle Aged
  • Male
  • Incidence
  • Humans
  • Heart Ventricles