摘要
Abstract
Objective To observe the long term prognosis effect of complete left bundle branch block ( LBBB) on pa-tients with ischemic cardiomyopathy .Methods From 2004 January to 2009 December , 899 ischemic cardiomyopathy patients with left ventricular angiography confirmed LVEF≤35%were enrolled, the ECG examination confirmed the presence of bun-dle branch block in 25 cases ( group LBBB ) .Select the same period 48 ischemic cardiomyopathy patients without bundle branch block as the control group .Through inpatient medical records , follow-up, re-admission review , telephone follow-up to evaluate the prognosis of the patients .Results Drinking history of group LBBB was higher than the control group (32.0%vs. 14.6%).In LBBB group, the ratio of patients with anterior wall myocardial infarction history was significantly higher than the control group (88.0%vs.75.0%), left atrial echocardiographic diameter and left ventricular end diastolic diameter greater than the patients in the control group [(41.0 ±6.9) mm vs.(37.0 ±3.8) mm,(65.0 ±5.3) mm vs.(60.0 ±4.8) mm], the proportion of combined lesions in the anterior descending and circumflex branch was higher than the control group (16.0%vs.8.3%), the differences were statistically significant ( P <0.01).All-cause mortality, hemodynamic endpoints ratio in LBBB group was obviously higher than that in control group , the differences were statistically significant (12.0%vs.6.3%, 64.0%vs.27.1%, P <0.01).Cox regression analysis showed: anterior wall myocardial infarction , left bundle branch block are risk factors of heart failure death , readmission , ventricular arrhythmia , heart transplant composite endpoint in ische-mic cardiomyopathy patients (RR=1.04, RR=1.13, P <0.01).Conclusion Complete left bundle branch block is risk factor of adverse outcomes in ischemic cardiomyopathy patients with LVEF ≤35%, compared with patients without bundle branch block , occurrence of all-cause mortality , heart failure readmission , heart transplantation are significantly increased in ischemic cardiomyopathy patients with LBBB .关键词
传导阻滞,左束支/心肌病,缺血性/预后Key words
Block,left bundle branch/Cardiomyopathy,ischemic/Prognosis
