Coronary angiographic and Echocardiographic findings in patients with Left bundle branch block

Abstract

Background and Objectives: Left bundle branch block is an electrical conduction disturbance that can be present with various cardiovascular diseases. Atherosclerosis is the most frequent underlying cause of ischemic heart disease with left bundle branch block. This study was carried out to analyze the angiographic and echocardiographic findings in patients with left bundle branch block. Left ventricular systolic function had also been assessed and correlated with measured QRS width and angiographic findings. Methods: A total of 100 patients with left bundle branch block, 66 males and 34 females, with a ratio of about 2:1 with an age ranged from 30-75years (mean age 58.5 ± 8.1 years). The study was conducted in Al-Sadr teaching hospital in Basrah, South of Iraq during the period from January 2009 to April 2010. Echocardiography was done for all patients to assess left ventricular function and regional wall motion abnormalities, Left ventricular systolic dysfunction was considered if the ejection fraction was less than 50%. The QRS width recorded from the ECG was calculated, and compared with echocardiographic and coronary angiographic findings. Coronary angiography was performed to define coronary lesions for all patients. Results: Fifty seven percent of patients had left bundle branch block of ischaemic origin and forty three percent of non ischaemic left bundle branch block. The predictors of ischaemic left bundle branch block were male, age older than 50 years, diabetes mellitus, and regional wall motion abnormalities. The QRS complex width as recorded from the ECG was predictor of left ventricular systolic dysfunction irrespective of other risk factors. Conclusion: Left bundle branch block was correlated with more extensive coronary heart disease and severe left ventricular dysfunction as studied by ECG, echocardiography and coronary angiography.