TY - JOUR
T1 - Effect of Bundle Branch Block Patterns on Mortality in Hospitalized Patients With Heart Failure
AU - Barsheshet, Alon
AU - Leor, Jonathan
AU - Goldbourt, Uri
AU - Garty, Moshe
AU - Schwartz, Roseline
AU - Behar, Solomon
AU - Luria, David
AU - Eldar, Michael
AU - Glikson, Michael
N1 - Funding Information:
The Heart Failure Survey in Israel 2003 was supported by the Israel Center for Disease Control, Ramat Gan, Israel; The Israel Medical Association, Ramat Gan, Israel; Teva, Petah Tiqva, Israel; Levant, Herzelia, Israel; Neopharm, Petah Tiqva, Israel; Pfizer, Herzelia, Israel; Aventis, Netania, Israel; Dexxon, Or Akiva, Israel; Medisson, Petah Tiqva, Israel; Novartis, Petah Tiqva, Israel; and Schering-Plough, Petah Tiqva, Israel.
PY - 2008/5/1
Y1 - 2008/5/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=43049110179&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2007.12.035
DO - 10.1016/j.amjcard.2007.12.035
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AN - SCOPUS:43049110179
SN - 0002-9149
VL - 101
SP - 1303
EP - 1308
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 9
ER -