Informace o publikaci

Ventricular conduction abnormalities as predictors of long-term survival in acute de novo and decompensated chronic heart failure

Autoři	TOLPPANEN Heli SIIRILA-WARIS Krista HARJOLA Veli-Pekka MARONO David PAŘENICA Jiří KREUTZINGER Philipp NIEMINEN Tuomo PAVLUŠOVÁ Marie TARVASMAKI Tuukka TWERENBOLD Raphael TOLONEN Jukka MIKLIK Roman NIEMINEN Markku S. ŠPINAR Jindřich MUELLER Christian LASSUS Johan
Rok publikování	2016
Druh	Článek v odborném periodiku
Časopis / Zdroj	ESC Heart Failure
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
Doi	http://dx.doi.org/10.1002/ehf2.12068
Obor	Kardiovaskulární nemoci včetně kardiochirurgie
Klíčová slova	Acute heart failure; Ventricular conduction; Bundle branch block; Prognosis; de novo
Popis	Aims Data on the prognostic role of left and right bundle branch blocks (LBBB and RBBB), and nonspecific intraventricular conduction delay (IVCD; QRS 110 ms, no BBB) in acute heart failure (AHF) are controversial. Our aim was to investigate electrocardiographic predictors of long-term survival in patients with de novo AHF and acutely decompensated chronic heart failure (ADCHF). Methods and Results We analysed the admission electrocardiogram of 982 patients from a multicenter European cohort of AHF with 3.9 years’ mean follow-up. Half (51.5%, n = 506) of the patients had de novo AHF. LBBB, and IVCD were more common in ADCHF than in de novo AHF: 17.2% vs. 8.7% (P 0.001) and 20.6% vs. 13.2% (P = 0.001), respectively, and RBBB was almost equally common (6.9% and 8.1%; P = 0.5), respectively. Mortality during the follow-up was higher in patients with RBBB (85.4%) and IVCD (73.7%) compared with patients with normal ventricular conduction (57.0%); P<0.001 for both. The impact of RBBB on prognosis was prominent in de novo AHF (adjusted HR 1.93, 1.03–3.60; P = 0.04), and IVCD independently predicted death in ADCHF (adjusted HR 1.79, 1.28–2.52; P = 0.001). Both findings were pronounced in patients with reduced ejection fraction. LBBB showed no association with increased mortality in either of the subgroups. The main results were confirmed in a validation cohort of 1511 AHF patients with 5.9 years’ mean follow-up. Conclusions Conduction abnormalities predict long-term survival differently in de novo AHF and ADCHF. RBBB predicts mortality in de novo AHF, and IVCD in ADCHF. LBBB has no additive predictive value in AHF requiring hospitalization.