| Correlates of bundle-branch block in patients undergoing primary angioplasty for acute myocardial infarction. | |
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MedLine Citation:
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PMID: 11768740 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Early reperfusion therapy has reduced the infarct size and mortality rate in patients with acute myocardial infarction (AMI). The occurrence of bundle-branch block in AMI is related to the amount of myocardial damage and the insult to the conduction system. HYPOTHESIS: To evaluate the clinical and angiographic factors related to the occurrence of bundle-branch block (BBB) in patients with primary percutaneous transluminal coronary angioplasty (PTCA), we investigated consecutive series of patients with their first Q-wave AMI and successful PTCA. METHODS: Coronary angiogram at the time of admission, electrocardiogram, and echocardiogram were evaluated in 279 patients with their first Q-wave AMI and successful PTCA. RESULTS: Bundle-branch block was detected in 26 patients (9%); 16 patients had transient and 10 patients had persistent block, while 16 patients had bifascicular block and 10 patients had right BBB. The patients with BBB had a significantly larger number of left ventricular asynergic segments, higher incidence of total occlusion of infarct-related artery, angiographic no reflow, and pericardial rub than those without BBB. When the multivariate analysis was performed using five clinical markers of infarct severity, angiographic no reflow (F = 20.2, p < 0.001) and total occlusion of infarct-re-lated artery (F = 4.2, p = 0.04) were found to be the significant variables related to BBB. CONCLUSIONS: Despite successful primary PTCA, absence of antegrade flow in the infarct-related artery at the onset of AMI and/or angiographic no reflow resulted in more severe transmural myocardial damage and, hence, the occurrence of BBB. |
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Authors:
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T Sugiura; F Yamasaki; K Hatada; S Nakamura; T Iwasaka |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical cardiology Volume: 24 ISSN: 0160-9289 ISO Abbreviation: Clin Cardiol Publication Date: 2001 Dec |
Date Detail:
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Created Date: 2001-12-21 Completed Date: 2002-02-28 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7903272 Medline TA: Clin Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 770-4 Citation Subset: IM |
Affiliation:
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Department of Clinical Laboratory Medicine, Kochi Medical School, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects Bundle-Branch Block / etiology* Coronary Angiography Female Humans Male Middle Aged Myocardial Infarction / complications*, therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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