| Association of uncomplicated electrocardiographic conduction blocks with subsequent cardiac morbidity in a community-based population (Olmsted County, Minnesota). | |
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MedLine Citation:
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PMID: 18157974 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Ventricular conduction blocks (VCBs) identified on a 12-lead electrocardiogram (ECG) are associated with poor outcomes in patients with known cardiac disease. The prognostic implications of uncomplicated VCB (right or left bundle branch block [RBBB or LBBB], left anterior hemiblock) in patients without cardiac diagnoses, however, need to be reevaluated in the current therapeutic era. The purpose of this study was to determine long-term cardiac morbidity and mortality in a community-based population with electrocardiographically-identified VCB, documented normal left ventricular ejection fraction, and no diagnoses of cardiac disease at the time of the index ECG. A retrospective observational cohort study was undertaken of patients in Olmsted County, Minnesota, evaluated from 1975 to 1999. Kaplan-Meier survival analysis post-index electrocardiography was performed with median follow-up of 9.0 years; 706 patients (mean age 64 +/- 16 [SE] years) were identified. Of those, 12% had LBBB with left-axis deviation (LAD); 20% had LBBB without LAD; 26% had left anterior hemiblock; and 42% had RBBB. Kaplan-Meier analysis indicated a significant difference in cardiovascular morbidity risk among the VCB groups (p = 0.017) with left anterior hemiblock and LBBB with LAD, and these were associated with the highest 10-year cardiovascular morbidity risk (58% and 68%, respectively). The incidence of dilated cardiomyopathy was 3% in patients with LBBB with LAD compared with 0.85% in the overall cohort. Significant mortality differences were also demonstrated between LBBB with LAD compared with LBBB without LAD (p = 0.048), left anterior hemiblock compared with LBBB without LAD (p <0.0001), and left anterior hemiblock compared with RBBB (p = 0.0007). In conclusion, the identification of uncomplicated VCB with LAD is associated with increased long-term cardiac morbidity/mortality risk, including the development of dilated and ischemic cardiomyopathy. Isolated VCB is an early marker of cardiac co-morbidities and potentially identifies a high-risk group of patients who warrant preventive intervention. |
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Authors:
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Wayne L Miller; David O Hodge; Stephen C Hammill |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 101 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2007-12-25 Completed Date: 2008-02-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 102-6 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. miller.wayne@mayo.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged Bundle-Branch Block / epidemiology* Cohort Studies Diabetes Mellitus / epidemiology Electrocardiography Female Follow-Up Studies Heart Diseases / epidemiology Humans Kaplan-Meiers Estimate Male Middle Aged Minnesota / epidemiology Retrospective Studies |
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