Left bundle branch block was an independent predictor of 1-year mortality in 4-week survivors of a severe acute heart failure episode (HR 2.01; 95% CI 1.12-3.64; P=0.02).
Cohort (n=403)
Does the presence of LBBB increase short- and long-term mortality in patients admitted for a severe acute heart failure episode?
In patients surviving a severe episode of de novo or mild-on-chronic acute heart failure, the presence of LBBB independently predicts 1-year mortality.
Effect estimate: HR 2.01 (95% CI 1.12-3.64)
p-value: p=0.02
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.
Huvelle et al. (Tue,) conducted a cohort in Acute Heart Failure Syndrome (n=403). Left bundle branch block (LBBB) vs. No LBBB was evaluated on 1-year mortality in 4-week survivors (HR 2.01, 95% CI 1.12-3.64, p=0.02). Left bundle branch block was an independent predictor of 1-year mortality in 4-week survivors of a severe acute heart failure episode (HR 2.01; 95% CI 1.12-3.64; P=0.02).