Coronary angiographic findings in patients with complete left bundle branch block in Erbil city /Iraq

Authors

  • Salah Hassan Yousif Department of Internal Medicine, Rizgary teaching hospital, Erbil, Iraq
  • Mohammed Hassan Alwan Department of Internal Medicine, College of Medicine, Hawler medical university, Erbil, Iraq

DOI:

https://doi.org/10.15218/zjms.2013.0007

Keywords:

left bundle branch block, coronary artery disease

Abstract

Background and objective: The goal of this study was to determine the association of complete left bundle branch block (LBBB), site , severity & risk factors of coronary artery disease (CAD). Complete Left bundle branch block increases the risk of cardiac mortality, and prognosis is primarily determined by the underlying CAD. Because the presence of complete LBBB makes the noninvasive identification of CAD less informative, patients with complete LBBB often are referred for coronary angiography to assess the presence and severity of CAD. Methods: A total of 150 consecutive patients with complete LBBB admitted to the coronary care unit were enrolled from the age of 27 to 81 years with the mean age of 59.32 ± 10.5. Male 84 (56%), Female (44%). History, basal investigations echocardiography and virology screen were performed. Coronary angiography has been done for all patients for different reasons of presentation. Results: Critical CAD 70 (46.7%), Left ventricular systolic dysfunction (LVSD) 50 (33.3%). Hypertension found in 83 (55.3%), diabetes mellitus (DM) in 44 (30%), DM& left ventricular systolic dysfunction(LVSD) were more associated with critical CAD. Conclusion: In our study complete LBBB was more common among hypertensive patients. In DM patients was associated with severe CAD. With Left anterior descending artery being the most common artery involved.

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References

Josephson, ME. Clinical Cardiac Electrophysiol ogy: Techniques and Interpretations. 2d ed, Lea&Febiger,Philadelphia,1993.

Francia P. Left bundle-branch block — Pathophysiology, prognosis and clinical management. Clinical Cardiology. 2007;30:110.

Schwartz PJ, Zipes DP: Autonomic modulation of cardiacarrhytmia.In: Zipes DP, Jalife J, ed. Cardiac Electrophysiology: From Cell to Bedside, 3rd ed. Philadelphia: WB Saunders; 1999:300-314.

riksson P. Hansson PO. Eriksson H. Dellborg M. Bundle-branch block in a general male population: the study of men born 1913. Circulation 1998; 98:2494.

Imanishi R. Seto S. Ichimaru. Prognostic significance of incident complete left bundle branch block observed over a 40-year period. Am J Cardiol 2006; 98:644.

Bavelaar-Croon CD. Wahba FF. van Hecke MV. Perfusion and functional abnormalities outside the septal region in patients with left bundle branch block assessed with gated SPECT. Q J Nucl Med 2001; 45:108–114.

McAnulty JH. Rahimtoola SH. Murphy E. Natural history of “high-risk” bundle-branch block: final report of a prospective study. N Engl J Med 1982;307:137– 43.

DePuey EG. Guertler-Krawczynska E. Robbins WL. Thallium-201 SPECT in coronary artery disease patients with left bundle branch block. J Nucl Med 1988;29:1479–85.

Iskandrian AE, Verani MS, editors. Nuclear Cardiac Imaging: Principles and Applications. 3rd ed. New York, NY: Oxford University Press, 2003:164–89.

Gibbons RJ, Balady JT, Chaitman BR. ACC/AHA 2002 Guidelines Update for Exercise Testing. Available at: www.acc.org. Accessed July 6, 2006.

Duncan AM, Francis DP, Gibson DG, Henein MY. Differentiation of ischemic from nonischemic cardiomyopathy during dobutamine stress by left ventricular long-axis function: additional effect of left bundle-branch block. Circulation 2003;108:1214 –20.

Geleijnse ML, Vigna C, Kasprzak JD. Usefulness and limitations of dobutamine-atropine stress echocardiography for the diagnosis of coronary artery disease in patients with left bundle branch block. A multicentre study. Eur Heart J 2000; 21:1666 –73.

Lev M, Kinare SG, Pick A. The pathogenesis of atrioventricular block in coronary disease. Circulation 1970; 42:409 –25.

Hesse, B, Diaz, L, Snader, CE. Complete bundle branch block as an independent predictor of all-cause mortality: Report of 7,073 patients referred for nuclear exercise testing. Am J Med 2001; 110:253.

Baldasseroni, S, Opasich, C, Gorini, M. Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: a report from the Italian network on congestive heart failure. Am Heart J 2002; 143:398.

Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997;20:1183-97.

Eoin O’Brien. Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self-blood pressure measurement. Journal of Hypertension 2005; 23:697–701.

Swedberg K, Cleland J, Dargie H: Guidelines for the diagnosis and treatment of chronic heart failure: Executive summary. Eur Heart J. 2005, 26: 1115-1140.

Tomas B. Garcia, Geoffrey T. Miller. Arrhythmia recognition. Sudbury, Mass.: Jones and Bartlett Publishers, 2004. isbn:0763722464.

Scolon P, Faxon D, Audei A.et al.ACC/AHA guideline for coronary angiography . J Am Coll Cardiol 1999; 33:1765

Schneider JF, Thomas HE, McNamara PM, Kannel WB. Clinical-electrocardiographic correlates of newly acquired left bundle branch block: the Framingham Study. Am J Cardiol 1985; 55: 1332-8.

Rajjit Abrol; Jeffrey C Trost; Keith Nguyen; Joaquin E Cigarroa; Sabina AMurphy: Predictors of Coronary Artery Disease in Patients with Left Bundle Branch Block Undergoing Coronary Angiography: Am J Cardiol. 2006; 10:1307-10.

Schneider JF. Thomas HE Jr, Kreger BE. Newly acquired left bundle branch block. The Framingham study. Ann Intern Med 1979; 90:303

Ozeke, O, Aras, D, Deveci, B. Comparison of presence and extent of coronary narrowing in patients with left bundle branch block without diabetes mellitus to patients with and without left bundle branch block but with diabetes mellitus. Am J Cardiol 2006; 97:857.

Tameem H. M. Alshami, Ou Mao, Yang Kan, et al. Complete left bundle branch block in patients with clinical and coronary angiographic analysis. H Complete left bundle branch block in patients with clinical and coronary angiographic analysis. Hunan Normal University (Medical Sciences), 2007; 4: 4748.

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Published

2013-04-01

How to Cite

Yousif, S. H., & Alwan, M. H. (2013). Coronary angiographic findings in patients with complete left bundle branch block in Erbil city /Iraq. Zanco Journal of Medical Sciences (Zanco J Med Sci), 17(1), 305_310. https://doi.org/10.15218/zjms.2013.0007

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Original Articles