Document Detail


Clinical and angiographic importance of right bundle branch block in the setting of acute anterior myocardial infarction.
MedLine Citation:
PMID:  18400632     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate functional status of patients (Killip class), left ventricular contractility, angiographic anatomy and severity of coronary lesions in patients with and without right bundle branch block (RBBB) in the setting of anterior myocardial infarction (MI). METHODS: Patients who admitted to coronary care unit with the diagnosis of acute anterior MI between 1999 and 2005 were retrospectively searched from our database. Out of 792 patients, 37 had RBBB (RBBB group) either at admission or in the course of anterior MI. Forty patients who developed no intraventricular conduction defect during the course of anterior MI with the same demographic characteristics were selected as the control group. RESULTS: Out of 37 patients, 30 had RBBB on admission and 7 developed RBBB in the course of acute MI. Left anterior descending artery (LAD) proximal lesion was more commonly detected in the RBBB group [23 (62.2%) vs. 11 (27.5%) patients, p=0.003]. Left ventricular ejection fraction was lower (33.0+/-4.2% vs 36.7+/-4.9%, p=0.003) and end-systolic volume was higher (84.1+/-24.9 ml vs 74.6+/-22.0 ml, p=0.012) in patients with RBBB. Number of patients with high Killip grade (III and IV) was more in the RBBB group [7 (18.9%) vs 3 (7.5%), RR: 1.75, %95 CI 0.92-3.32, p=0.14], and number of patients with Killip grade I was more in the control group [34 (85.0%) vs 22 (59.5%), p=0.012]. Besides mean Killip class was higher in the RBBB group (1.65+/-0.90 vs 1.25+/-0.67, p=0.03). Three patients (8.1%) in the RBBB group and 2 patients (5.0%) in the control group died during hospitalization (p=0.67). CONCLUSION: Left ventricular ejection fraction decreases and Killip grade increases in case of RBBB in the setting of acute anterior MI. Culprit lesion in patients with RBBB is more commonly a LAD proximal lesion and threatened myocardial tissue is larger in patients with RBBB.
Authors:
Uğur Arslan; Serhat Balcioğlu; Yusuf Tavil; Murat Ozdemir; Atiye Cengel
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology     Volume:  8     ISSN:  1308-0032     ISO Abbreviation:  Anadolu Kardiyol Derg     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-10     Completed Date:  2008-06-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101095069     Medline TA:  Anadolu Kardiyol Derg     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  123-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey. ugurarslan5@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Bundle-Branch Block / complications,  pathology,  physiopathology*,  radiography
Case-Control Studies
Coronary Angiography
Female
Humans
Male
Middle Aged
Myocardial Infarction / complications,  pathology,  physiopathology*,  radiography
Retrospective Studies
Severity of Illness Index
Stroke Volume
Ventricular Dysfunction, Left / complications,  pathology,  physiopathology*,  radiography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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