Aneta Aleksova1, Cosimo Carriere2, Massimo Zecchin2, Giulia Barbati2, Giancarlo Vitrella2, Andrea Di Lenarda3, Gianfranco Sinagra2. 1. Cardiovascular Department, 'Ospedali Riuniti' and University of Trieste, Via Valdoni 7, 34100 Trieste, Italy aaleksova@units.it aaleksova@gmail.com. 2. Cardiovascular Department, 'Ospedali Riuniti' and University of Trieste, Via Valdoni 7, 34100 Trieste, Italy. 3. Cardiovascular Centre, Territorial Health Service of Trieste, 34100, Trieste, Italy.
Abstract
AIMS: Left bundle branch block (LBBB) is commonly associated with heart failure. We evaluated the prevalence, incidence, and impact of LBBB on long-term outcome in young patients with heart failure affected by idiopathic dilated cardiomyopathy (DCM). METHODS AND RESULTS: We included 608 patients with DCM from the Heart Muscle Disease Registry of Trieste in this retrospective analysis. At baseline electrocardiogram (ECG), 189 patients (31.1%) had LBBB. The patients with baseline LBBB had a significantly higher mortality rate than the patients without LBBB (38.6 vs. 27.9%, P = 0.002) at the univariate analysis. After a multiple covariate adjustment, the baseline LBBB was not associated with a significantly increased risk of death [hazard ratio (HR) 1.27, 95% confidence interval (CI): 0.88-1.81, P = 0.2]. Forty-seven (11.2%) patients without LBBB at baseline ECG developed LBBB during follow-up. Among these, the mortality rate was 49 vs. 25% in patients without new-onset LBBB (P = 0.001). New-onset LBBB was a strong and independent predictor of all-cause mortality (HR 3.18, 95% CI: 1.90-5.31, P < 0.001) at multivariate analysis. CONCLUSION: After correcting for potential confounders, new-onset LBBB was found to be associated with an increased risk of all-cause mortality. The management of patients with new-onset LBBB may need to be more aggressive, possibly including early cardiac resynchronization therapy/implantable cardioverter-defibrillator therapy. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Left bundle branch block (LBBB) is commonly associated with heart failure. We evaluated the prevalence, incidence, and impact of LBBB on long-term outcome in young patients with heart failure affected by idiopathic dilated cardiomyopathy (DCM). METHODS AND RESULTS: We included 608 patients with DCM from the Heart Muscle Disease Registry of Trieste in this retrospective analysis. At baseline electrocardiogram (ECG), 189 patients (31.1%) had LBBB. The patients with baseline LBBB had a significantly higher mortality rate than the patients without LBBB (38.6 vs. 27.9%, P = 0.002) at the univariate analysis. After a multiple covariate adjustment, the baseline LBBB was not associated with a significantly increased risk of death [hazard ratio (HR) 1.27, 95% confidence interval (CI): 0.88-1.81, P = 0.2]. Forty-seven (11.2%) patients without LBBB at baseline ECG developed LBBB during follow-up. Among these, the mortality rate was 49 vs. 25% in patients without new-onset LBBB (P = 0.001). New-onset LBBB was a strong and independent predictor of all-cause mortality (HR 3.18, 95% CI: 1.90-5.31, P < 0.001) at multivariate analysis. CONCLUSION: After correcting for potential confounders, new-onset LBBB was found to be associated with an increased risk of all-cause mortality. The management of patients with new-onset LBBB may need to be more aggressive, possibly including early cardiac resynchronization therapy/implantable cardioverter-defibrillator therapy. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: David Y Barefield; Sean Yamakawa; Ibrahim Tahtah; Jordan J Sell; Michael Broman; Brigitte Laforest; Sloane Harris; Alejandro Alvarez-Arce; Kelly N Araujo; Megan J Puckelwartz; J Andrew Wasserstrom; Glenn I Fishman; Elizabeth M McNally Journal: J Mol Cell Cardiol Date: 2022-05-06 Impact factor: 5.763