1. Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure
- Author
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Cinca, Juan, Mendez, Ana, Puig, Teresa, Ferrero-Gregori, Andreu, Roig, Eulàlia, Vazquez, Rafael, Gonzalez-Juanatey, Jose R., Alonso-Pulpón, Luis, Delgado, Juan, Brugada, Josep, Pascual-Figal, Domingo, Batlle, Montserrat, Berruezo, Antonio, Hevia, S., Mont, L., Pérez-Villa, Félix, Bayés de Luna, Antonio, Borràs, Xavier, Carreras, F., Guerra Ramos, José María., Hove-Madsen, L., Jorge, E., Martínez, R., Padró Fernández, José María, Puig, T., Ribas, N., Viñolas, X., Alvarez-Garcia, Jesus, González-Juanatey, José R, Bandín, M., Eiras, S., Fernández-Hernández, L., García-Acuña, J., Gómez-Otero, I., Grigorian-Shamagian, L., Lago, F., Manzón, P., Moure, M., Otero-Raviña, F., Otero-Santiago, F., Rodino Janeiro, B. K., Rubio, J., Salgado, A., Seoane, A., Varela, A., Lear, P. V., Fernández-Cruz, Ana, Alvarez de Arcaya Vicente, A., Avila, M., Bordiu, E., Calle, L., Fernández-Pinilla, C., Gómez-Garre, D., González-Rubio, L., Marco, J., Martell, N., Muñoz-Pacheco, P., Ortega, A., Patiño, R., Pedrajas, J., Reinares, L., Pérez-Villacastín, J., Bover, R., Cobos, M., García-Quintanilla, J., Moreno, J., Pérez-Castellano, N., Pérez-Serrano, M., Vila, I., Delgado, J. F., Arribas, F., Escribano, Pilar, Flox, A., Jiménez López-Guarch, C., Paradina, M., Ruiz-Cano, J., Sáenz de la Calzada, C., Salguero, Rafael, Sánchez-Sánchez, V., Tello de Meneses, R., Vicente-Hernández, M., Fernández Lozano, Ignacio, García-Pavía, P., García-Touchard, A., Gómez-Bueno, M., Márquez, J., Segovia, J., Silva, L., Vázquez-Mosquera, M., Valdés, M., García-Alberola, A., Garrido, Iris, Pascual-Figal, D. A., Pastor-Pérez, F. J., Sánchez-Más, J., Tornel, P., Rivera, M., Almenar Bonet, Luis, Cortés, R., Martínez-Dolz, L., Montero, J., Portolés, M., Roselló-Lleti, E., Salvador, A., Vila, V., Vázquez, R., Cubero, J., Fernández-Palacín, A., García-Medina, D., García-Rey, Silvia, Laguna, E., Leal del Ojo, J., Miñano, F., Pastor-Torres, L., Pavón, R., Pérez-Navarro, Mª Amparo, Villagómez, D., Arana, R., Bartolomé, D., Cabeza, P., Calle-Pérez, G., Camacho, F., Cano, L., Carrillo, A., Díaz-Retamino, E., Escolar, V., Fernández-Rivero, R., Gamaza, S., Giráldes, A., Hernández-Vicente, N., Lagares, M., López-Benítez, J., Marante, M., Otero, E., Pedregal, J., Sancho-Jaldón, M., Sevillano, R., Zayas, R., Verdú, J. M., Aguilar, S., Aizpurúa, M., Alguacil, F., Casacuberta, J., Cerain, J., Domingo, Mariano, García-Lareo, M., Herrero-Melechón, J., López-Pareja, N., Mena, A., Pérez-Orcero, A., Rodríguez- Cristóbal, J., Rozas, M., Sorribes, J., Torán, P., Worner, F., Barta, L., Bravo, C., Cabau, J., Casanova, J., Daga, B., De la Puerta, I., Hernández-Martín, I., Piñol, E., Pueo, E., Torres, G., Troncoso, A., Viles, D., Bardají, Alfredo, Mercè, J., Sanz-Girgas, E., Valdovinos, P., Aramburu, O., Arias, J., García-González, C., Alonso, M., Bischofberger, C., Domínguez-De Pablos, G., Jiménez-Cervantes, D., Ureña, I., Grau-Sepúlveda, A., Fiol, C., Pericas, P., Villalonga, M., Orosa, P., Agüero, Jaume, Planas-Aymá, F., Grau-Amoros, J., Planas-Comes, F., San Vicente, L., and Universitat Autònoma de Barcelona
- Subjects
Cardiomyopathy, Dilated ,Male ,medicine.medical_specialty ,Bundle-Branch Block ,Myocardial Ischemia ,Heart failure ,Outcomes ,Sudden death ,Patient Readmission ,Ventricular Function, Left ,Diabetes Complications ,Internal medicine ,medicine ,Humans ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,Heart Failure ,Ejection fraction ,Bundle branch block ,Proportional hazards model ,business.industry ,Stroke Volume ,Right bundle branch block ,Middle Aged ,medicine.disease ,Prognosis ,Case-Control Studies ,Hypertension ,Cardiology ,Female ,Left anterior fascicular block ,Cardiology and Cardiovascular Medicine ,Mitral valve regurgitation ,business - Abstract
Aims: Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Methods and results: Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. Conclusion: LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted. © The Author 2013.
- Published
- 2013