Document Detail


Left bundle branch block and mortality in patients with acute heart failure syndrome: a substudy of the EFICA cohort.
MedLine Citation:
PMID:  20028696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: In patients with chronic heart failure (CHF), left bundle branch block (LBBB) is associated with an increased risk of cardiovascular mortality. We aimed to investigate the association of LBBB with short- and long-term outcome in patients discharged after a de novo episode of acute heart failure (AHF) or AHF complicating a mild CHF.
METHODS AND RESULTS: Patients with no history of New York Heart Association class III and IV CHF, who were admitted for a severe AHF episode and enrolled in the prospective observational EFICA study (n = 403), were included. Left bundle branch block prevalence was 16%. Patients with LBBB had a higher prevalence of dilated cardiomyopathy (23 vs. 10%, P < 0.005), a higher percentage of AHF episodes without identified precipitating factor (15 vs. 2%, P < 0.001), and were less likely to present increased markers of cardiac injury (41 vs. 56%, P = 0.04). The 4-week mortality was 24.8% with no difference between LBBB and no LBBB patients. Left bundle branch block was however an independent predictor of 1-year mortality in the 4-week survivors [hazards ratio (95% confidence interval) = 2.01 (1.12-3.64), P = 0.02].
CONCLUSION: Long-term outcome of patients surviving a severe episode of de novo AHF or AHF complicating a mild CHF is worsened by LBBB. These patients may constitute a subgroup at high risk in whom specific therapeutic solutions should be investigated.
Authors:
Etienne Huvelle; Renaud Fay; François Alla; Alain Cohen Solal; Alexandre Mebazaa; Faiez Zannad
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-12-21
Journal Detail:
Title:  European journal of heart failure     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-19     Completed Date:  2011-01-20     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  156-63     Citation Subset:  IM    
Affiliation:
CIC-INSEM-CHU, Nancy, Hôpital Jeanne d'Arc, BP 90303, 54201 Toul Cedex, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Bundle-Branch Block / epidemiology,  mortality*
Cohort Studies
Confidence Intervals
Female
France / epidemiology
Heart Failure / epidemiology,  mortality*
Humans
Kaplan-Meier Estimate
Male
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors

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


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