Effect of Bundle Branch Block Patterns on Mortality in Hospitalized Patients With Heart Failure
| Autor: | Michael Glikson, Alon Barsheshet, Roseline Schwartz, Moshe Garty, Uri Goldbourt, David Luria, Solomon Behar, Jonathan Leor, Michael Eldar |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Hospitalized patients Bundle-Branch Block Statistics Nonparametric QRS complex Risk Factors Internal medicine medicine Humans Hospital Mortality Prospective Studies Israel Aged Aged 80 and over Heart Failure Univariate analysis Chi-Square Distribution Ejection fraction Bundle branch block business.industry Odds ratio Prognosis medicine.disease Survival Analysis Confidence interval Heart failure Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 101:1303-1308 |
| ISSN: | 0002-9149 |
| Popis: | A widened QRS interval is associated with increased mortality in patients with heart failure (HF). However, the prognostic significance of the type of bundle branch block (BBB) pattern in these patients is unclear. The data of 4,102 patients with HF hospitalized during a prospective national survey were analyzed to investigate the association between BBB type and 1-year mortality in 3,737 patients without pacemakers. Right BBB (RBBB) was present in 381 patients (10.2%) and left BBB (LBBB) in 504 patients (13.5%). RBBB and LBBB were associated with increased 1-year mortality on univariate analysis (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.15 to 1.81, and OR 1.20, 95% CI 0.97 to 1.47, respectively). In patients with systolic HF, after adjusting for multiple risk factors, only RBBB was found to be an independent predictor of mortality (RBBB vs no BBB OR 1.62, 95% CI 1.12 to 2.33, and RBBB vs LBBB OR 1.71, 95% CI 1.09 to 2.69). This correlation was stronger in patients with lower left ventricular ejection fractions and was also maintained in patients without acute myocardial infarctions. Analyzing the data for all patients with HF, there was a trend for increased mortality in the RBBB group only (adjusted OR 1.21, 95% CI 0.94 to 1.56). LBBB was not related to mortality in patients with either systolic HF or preserved ejection fractions. In conclusion, RBBB rather than LBBB is an independent predictor of mortality in hospitalized patients with systolic HF. This prognostic marker could be used for risk stratification and the selection of treatment. |
| Databáze: | OpenAIRE |
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