OBJECTIVE: The prognostic significance of left and right bundle branch block (LBBB and RRBB) in patients with chronic stable cardiovascular (CV) disease is not well characterized and was evaluated in the Heart Outcomes Prevention Evaluation (HOPE) study cohort. DESIGN: Observational analysis of data prospectively collected in the HOPE trial. SETTING AND PATIENTS: HOPE was a multicenter, international trial, which evaluated ramipril and vitamin E in 9,541 patients aged > or = 55 years with CV disease or diabetes with > or = 1CV risk factor(s) but without heart failure (HF) or known left ventricular systolic dysfunction. Follow-up extended for a median of 4.5 years. Electrocardiograms were obtained at baseline in all study participants and were read centrally. MAIN OUTCOME MEASURES: Major CV events (defined as CV death, myocardial infarction, or stroke), heart failure, CV death, all-cause death, and sudden death. RESULTS:Baseline LBBB was present in 246 (2.6%) patients and was associated with increased risk for major CV events (HR = 1.54; 95% CI, 1.18-2.02), CV death (HR 2.29; 95% CI, 1.63-3.20), heart failure (HR 2.99; 95% CI, 2.31-3.87), sudden death (HR 3.17; 95% CI, 2.13-4.73), and all-cause death (HR = 2.10; 95% CI, 1.59-2.77). In multivariate models, LBBB remained an independent predictor of heart failure, sudden death, CV death, and all-cause death (P < or = 0.002 for all). Baseline RBBB was present in 428 (4.5%) of patients and was not associated with increased CV risk. CONCLUSIONS: In patients with stable chronic CV disease, LBBB but not RBBB is an independent predictor of heart failure, sudden death, CV death, and all-cause death.
RCT Entities:
OBJECTIVE: The prognostic significance of left and right bundle branch block (LBBB and RRBB) in patients with chronic stable cardiovascular (CV) disease is not well characterized and was evaluated in the Heart Outcomes Prevention Evaluation (HOPE) study cohort. DESIGN: Observational analysis of data prospectively collected in the HOPE trial. SETTING AND PATIENTS: HOPE was a multicenter, international trial, which evaluated ramipril and vitamin E in 9,541 patients aged > or = 55 years with CV disease or diabetes with > or = 1 CV risk factor(s) but without heart failure (HF) or known left ventricular systolic dysfunction. Follow-up extended for a median of 4.5 years. Electrocardiograms were obtained at baseline in all study participants and were read centrally. MAIN OUTCOME MEASURES: Major CV events (defined as CV death, myocardial infarction, or stroke), heart failure, CV death, all-cause death, and sudden death. RESULTS: Baseline LBBB was present in 246 (2.6%) patients and was associated with increased risk for major CV events (HR = 1.54; 95% CI, 1.18-2.02), CV death (HR 2.29; 95% CI, 1.63-3.20), heart failure (HR 2.99; 95% CI, 2.31-3.87), sudden death (HR 3.17; 95% CI, 2.13-4.73), and all-cause death (HR = 2.10; 95% CI, 1.59-2.77). In multivariate models, LBBB remained an independent predictor of heart failure, sudden death, CV death, and all-cause death (P < or = 0.002 for all). Baseline RBBB was present in 428 (4.5%) of patients and was not associated with increased CV risk. CONCLUSIONS: In patients with stable chronic CV disease, LBBB but not RBBB is an independent predictor of heart failure, sudden death, CV death, and all-cause death.
Authors: Zhu-Ming Zhang; Pentti M Rautaharju; Ronald J Prineas; Laura Loehr; Wayne Rosamond; Elsayed Z Soliman Journal: J Card Fail Date: 2015-01-09 Impact factor: 5.712
Authors: Matthew G Whitbeck; Richard J Charnigo; Jignesh Shah; Gustavo Morales; Steve W Leung; Brandon Fornwalt; Alison L Bailey; Khaled Ziada; Vincent L Sorrell; Milagros M Zegarra; Jenks Thompson; Neil Aboul Hosn; Charles L Campbell; John Gurley; Paul Anaya; David C Booth; Luigi Di Biase; Andrea Natale; Susan Smyth; David J Moliterno; Claude S Elayi Journal: Europace Date: 2013-12-23 Impact factor: 5.214
Authors: Zhu-ming Zhang; Pentti M Rautaharju; Elsayed Z Soliman; Joann E Manson; Lisa W Martin; Marco Perez; Mara Vitolins; Ronald J Prineas Journal: Circ Heart Fail Date: 2013-05-31 Impact factor: 8.790
Authors: Gül Erdemli; Albert M Kim; Haisong Ju; Clayton Springer; Robert C Penland; Peter K Hoffmann Journal: Front Pharmacol Date: 2012-01-26 Impact factor: 5.810
Authors: Heli Tolppanen; Krista Siirila-Waris; Veli-Pekka Harjola; David Marono; Jiri Parenica; Philipp Kreutzinger; Tuomo Nieminen; Marie Pavlusova; Tuukka Tarvasmaki; Raphael Twerenbold; Jukka Tolonen; Roman Miklik; Markku S Nieminen; Jindrich Spinar; Christian Mueller; Johan Lassus Journal: ESC Heart Fail Date: 2015-10-30