Predictors of Left Ventricular Function Deterioration in Patients With Left Bundle Branch Block and Ejection Fraction >50%
Article first published online: 15 APR 2013
© 2013 Wiley Periodicals, Inc.
Congestive Heart Failure
Volume 19, Issue 4, pages E1–E4, July/August 2013
How to Cite
Angheloiu, G. O., Saul, M., Edelman, K., Shah, H., Mezu, U. L. and Saba, S. (2013), Predictors of Left Ventricular Function Deterioration in Patients With Left Bundle Branch Block and Ejection Fraction >50%. Congestive Heart Failure, 19: E1–E4. doi: 10.1111/chf.12028
- Issue published online: 1 AUG 2013
- Article first published online: 15 APR 2013
- Manuscript Accepted: 6 FEB 2013
- Manuscript Received: 9 NOV 2012
Resynchronization therapy has become standard of care in patients with left bundle branch block (LBBB), congestive heart failure (CHF), and low ejection fraction (EF). In order to characterize the left ventricular (LV) function evolution in patients with LBBB and baseline preserved LVEF, records of all patients who visited an academic echocardiography laboratory during a period of 4 years were retrospectively investigated. Patients were included if they had a baseline EF >50%, LBBB on surface electrocardiography, and at least one follow-up echocardiogram no earlier than 3 months after the baseline study. The endpoint was the occurrence of EF deterioration to values ≤40%. Clinical variables associated with this outcome were identified. Forty-nine patients satisfied the entry criteria. Over a mean 13±8.5 months of follow-up (range 3 to 36), 8 patients (16%) experienced EF deterioration ≤40%. History of CHF prior to baseline echocardiogram and LV mass >300 g were associated with this phenomenon (P=.004 and P=.015, respectively), with a negative predictive value of 100% and 92%, respectively. Our data profiles a risk-stratification methodology in patients with LBBB and baseline EF >50% and possibly a triage strategy toward resynchronization therapy in this population.