Angiographic pattern of patients with left bundle branch block: A comparative cross-sectional study

Abstract

Objectives: We purposed to determine the relationship between left bundle branch block (LBBB) and coronary artery disease (CAD) site, severity, and CAD risk factors. Methods: Eighty patients with LBBB were sorted into two groups based on coronary angiography (CA) findings: Group 1: 56 patients with CAD (stenosis ≥70% in ≥1 epicardial vessel) and Group 2: 24 patients with normal coronaries. Results: Our observations confirm male preponderance of LBBB and affirm hypertension and diabetes as common risk factors for CAD within this subpopulation. Hence, these risk factors can be considered a strong predictor of CAD in LBBB. Cardiac echocardiography data suggest that LBBB and CAD are associated with regional hypokinesia and decreased ejection fraction. The most frequently diseased vessel was left anterior descending (LAD), followed by left circumflex then right coronary artery. Our study CA showed single-vessel disease (SVD) in 37 participants (46.3%), two-vessel disease in 16 subjects (20%), three-vessel disease in 3 subjects (3.8%), and normal vessels in 24 participants (30%). Hence, SVD frequency was high in our study. Conclusion: The risk for left ventricular dysfunction and SVD more commonly LAD artery involvement had increased in the presence of LBBB in electrocardiogram. CA present only in tertiary centers, which considered a major and invasive diagnostic tool for CAD, so selection criteria are required to predict patients with LBBB who are prone to be at risk of CAD and need this invasive procedure, on the other hand, avoid CAD overdiagnosis, unnecessary admissions to hospital, and antianginal drugs consumption.

Keywords

• coronary angiography
• coronary artery disease
• ischemic heart disease
• left bundle branch block
• left ventricular dysfunction