CARDIAC REMODELLING AND CLINICAL PROGNOSIS IN PATIENTS WITH CHRONIC HEART FAILURE AND COMPLETE LEFT BUNDLE BRANCH BLOCK

Abstract

Aim: To investigate echocardiography (EchoCG) parameters and clinical prognosis in elderly patients with chronic heart failure (CHF) and complete left bundle branch block (LBBB). Material and methods: The study included 248 patients (163 men and 85 women), aged 60–85 years, with Functional Class II–IV CHF (NYHA classification) due to coronary heart disease (CHD) and arterial hypertension (AH). All participants were divided into two groups: Group I (n=37) included patients with complete LBBB, while Group II (n=211) included patients without LBBB. Results: In 14,9% of the elderly CHF patients, complete LBBB was observed. Group I and II patients were comparable by age, gender, CHF duration, and hemodynamic parameters. However, clinical course of CHF was more severe in participants with complete LBBB. LBBB was associated with myocardial infarction (MI) in anamnesis (p=0,029; odds ratio, OR, 5,11; 95% confidence interval, CI, 1,19–22,03), anterior MI (р=0,020; OR 3,03; 95% CI 1,19–1,71), left ventricular (LV) end-diastolic dimension (р=0,001; OR 2,09; 95% CI 1,35–3,26), LV end-systolic dimension (р=0,001; OR 1,98; 95% CI 1,34–2,95), LV end-diastolic volume (р=0,001; OR 1,012; 95% CI 1,01–1,02), LV end-systolic volume (р=0,002; OR 1,01; 95% CI 1,01–1,02), and low LV ejection fraction (EF) (р=0,003; OR 1,05; 95% CI 1,02–1,08). Over the follow-up period, the survival levels in elderly CHF patients with or without LBBB were 59,5% and 76,8%, respectively. The leading mortality cause in patients with LBBB was sudden death. Conclusion: Complete LBBB was associated with LV remodelling progression. Sudden death was the leading mortality cause in LBBB patients.

Keywords

• left bundle branch block
• lv remodelling progression
• mortality