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Prognostic Implication of Ventricular Conduction Disturbance Pattern in Hospitalized Patients with Acute Heart Failure Syndrome

Authors
 Ji Hyun Lee  ;  Jin Joo Park  ;  Youngjin Cho  ;  Il-Young Oh  ;  Byung-Su Yoo  ;  Jae-Joong Kim  ;  Kye Hun Kim  ;  Seok-Min Kang  ;  Sang Hong Baek  ;  Eun-Seok Jeon  ;  Myeong-Chan Cho  ;  Shung Chull Chae  ;  Byung-Hee Oh  ;  Dong-Ju Choi 
Citation
 Korean Circulation Journal, Vol.49(7) : 602-611, 2019 
Journal Title
 Korean Circulation Journal 
ISSN
 1738-5520 
Issue Date
2019
Keywords
Bundle branch block ; Cardiac conduction system disease ; Heart failure ; Prognosis
Abstract
BACKGROUND AND OBJECTIVES: Conflicting data exist regarding the prognostic implication of ventricular conduction disturbance pattern in patients with heart failure (HF). This study investigated the prognostic impact of ventricular conduction pattern in hospitalized patients with acute HF. METHODS: Data from the Korean Acute Heart Failure registry were used. Patients were categorized into four groups: narrow QRS (<120 ms), right bundle branch block (RBBB), left bundle branch block (LBBB), and nonspecific intraventricular conduction delay (NICD). The NICD was defined as prolonged QRS (≥120 ms) without typical features of LBBB or RBBB. The primary endpoint was the composite of all-cause mortality or rehospitalization for HF aggravation within 1 year after discharge. RESULTS: This study included 5,157 patients. The primary endpoint occurred in 39.7% of study population. The LBBB group showed the highest incidence of primary endpoint followed by NICD, RBBB, and narrow QRS groups (52.5% vs. 49.7% vs. 44.4% vs. 37.5%, p<0.001). In a multivariable Cox-proportional hazards regression analysis, LBBB and NICD were associated with 39% and 28% increased risk for primary endpoint (LBBB hazard ratio [HR], 1.392; 95% confidence interval [CI], 1.152-1.681; NICD HR, 1.278; 95% CI, 1.074-1.520) compared with narrow QRS group. The HR of RBBB for the primary endpoint was 1.103 (95% CI, 0.915-1.329). CONCLUSIONS: LBBB and NICD were independently associated with an increased risk of 1-year adverse event in hospitalized patients with HF, whereas the prognostic impacts of RBBB were limited. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01389843.
Files in This Item:
T201902607.pdf Download
DOI
10.4070/kcj.2018.0290
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/171015
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