Predictors and prognostic impact of new left bundle branch block after surgical aortic valve replacement.

Autor: Khounlaboud M; Service de cardiologie et maladies vasculaires, hôpital Pontchaillou/CHU, 35000 Rennes, France; Service de cardiologie, centre hospitalier, 10, rue Marcel-Proust, 22000 Saint-Brieuc, France. Electronic address: moukda.khounlaboud@ch.stbrieuc.fr., Flécher E; Service de chirurgie cardiaque, thoracique et vasculaire, hôpital Pontchaillou/CHU, 35000 Rennes, France; Faculté de médecine, université de Rennes 1, 35000 Rennes, France; LTSI Inserm U1099, 35000 Rennes, France., Fournet M; Service de cardiologie et maladies vasculaires, hôpital Pontchaillou/CHU, 35000 Rennes, France., Le Breton H; Service de cardiologie et maladies vasculaires, hôpital Pontchaillou/CHU, 35000 Rennes, France; Faculté de médecine, université de Rennes 1, 35000 Rennes, France; LTSI Inserm U1099, 35000 Rennes, France., Donal E; Service de cardiologie et maladies vasculaires, hôpital Pontchaillou/CHU, 35000 Rennes, France; Faculté de médecine, université de Rennes 1, 35000 Rennes, France; LTSI Inserm U1099, 35000 Rennes, France., Leclercq C; Service de cardiologie et maladies vasculaires, hôpital Pontchaillou/CHU, 35000 Rennes, France; Faculté de médecine, université de Rennes 1, 35000 Rennes, France; LTSI Inserm U1099, 35000 Rennes, France., Mabo P; Service de cardiologie et maladies vasculaires, hôpital Pontchaillou/CHU, 35000 Rennes, France; Faculté de médecine, université de Rennes 1, 35000 Rennes, France; LTSI Inserm U1099, 35000 Rennes, France., Leguerrier A; Service de chirurgie cardiaque, thoracique et vasculaire, hôpital Pontchaillou/CHU, 35000 Rennes, France; Faculté de médecine, université de Rennes 1, 35000 Rennes, France; LTSI Inserm U1099, 35000 Rennes, France., Daubert C; Faculté de médecine, université de Rennes 1, 35000 Rennes, France; LTSI Inserm U1099, 35000 Rennes, France.
Jazyk: angličtina
Zdroj: Archives of cardiovascular diseases [Arch Cardiovasc Dis] 2017 Dec; Vol. 110 (12), pp. 667-675. Date of Electronic Publication: 2017 Sep 28.
DOI: 10.1016/j.acvd.2017.03.007
Abstrakt: Background: Left bundle branch block (LBBB) induces mechanical dyssynchrony that may lead to left ventricular systolic dysfunction.
Aims: To evaluate the incidence, predictors and clinical impact of new LBBB in patients undergoing surgical aortic valve replacement (SAVR).
Methods: After exclusion of patients with pre-existing LBBB, a previous pacemaker or a paced rhythm at hospital discharge, 547 consecutive patients undergoing SAVR were included. All-cause death, cardiovascular death and the combined outcome of all-cause death or a first heart failure event were assessed at 3months and 1year. Patients with and without new LBBB were compared.
Results: New LBBB occurred in 4.6% of patients after SAVR (compared with 16.4% of patients treated by transcatheter aortic valve implantation during the study period). Previous valve surgery and an immediate postoperative paced rhythm were independent predictors of new LBBB. At 1-year follow-up, there were no significant differences in all-cause death, cardiovascular death, or the combined outcome of all-cause death or a first heart failure event between patients with and without new LBBB. However, new LBBB was associated with a trend towards functional deterioration and more heart failure events at 1year.
Conclusion: At 1-year follow-up, new LBBB did not have a significant impact on clinical outcome, but was associated with worse functional status and more heart failure events.
(Copyright © 2017. Published by Elsevier Masson SAS.)
Databáze: MEDLINE
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