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264318

Left Bundle Branch Block: What Does it Hide? Clinical, Echocardiographic, and Angiographic Study

Article

Last updated: 22 Jan 2023

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Clinical Research (Medical)

Abstract

Background: In patients with left bundle branch block (LBBB), prediction of obstructive coronary artery disease (OCAD) could select patients indicated for coronary angiography (CA). Aim: Evaluate clinical and echocardiographic features, angiographic patterns, and non-invasive predictors of OCAD in subjects with LBBB. Subjects and Methods: Patients with LBBB underwent clinical assessment, detailed echocardiography, and elective CA. We recruited 68 patients with OCAD and 44 patients with normal CA (NCA), both groups were age- and sex-matched. Results: Patients with OCAD compared to the NCA group had significantly higher CHA2DS2-VASc-HSF scores, diabetes mellitus, dyslipidemia, fragmented wide QRS complex, concordant STT changes, and left ventricular mass index. Heart failure affected 32 (28.57%) of our patients with no significant difference between both groups. Conventional echocardiography and tissue Doppler imaging showed no significant differences between both groups regarding parameters of systolic and diastolic functions as ejection fraction, and the ratio of late diastolic transmitral flow velocity (E) to early diastolic mitral annular tissue velocity (E/E` ratio). Whereas Speckle tracking echocardiography (STE) showed a significantly lower early global diastolic strain rate (E`sr), higher E/E`sr ratio, and worse global longitudinal strain (GLS). Independent predictors of OCAD in patients with LBBB included CHA2DS2-VASc-HSF score > 3.5, QRS duration > 148.5 milliseconds, E/E`sr ratio > 171.31 centimeter, and GLS worse than -14.5%. Conclusion: Systolic and diastolic dysfunction and the predictors of OCAD in patients with LBBB were better evaluated by STE. Clinical assessment and non-invasive imaging of patients with LBBB would help to select patients who need invasive strategies.  

DOI

10.21608/scumj.2022.264318

Keywords

Left bundle branch block, Coronary Artery Disease, Coronary angiography

Authors

First Name

Abdulsalam

Last Name

Algamal

MiddleName

M.

Affiliation

Cardiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

abdo75gamal@mans.edu.eg

City

-

Orcid

0000-0002-5275-693X

First Name

Mahmoud

Last Name

Salem

MiddleName

A.

Affiliation

Cardiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

dr_mahmoud_badie@yahoo.com

City

-

Orcid

-

First Name

Hany

Last Name

Abdel Shakour

MiddleName

M.

Affiliation

Cardiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

hany.abdel.shakour@gmail.com

City

-

Orcid

-

First Name

Shady

Last Name

Elhusseiny

MiddleName

H.

Affiliation

Cardiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

shadycardiology@gmail.com

City

-

Orcid

-

Volume

25

Article Issue

3

Related Issue

36846

Issue Date

2022-10-01

Receive Date

2022-10-06

Publish Date

2022-10-01

Print ISSN

1110-6999

Online ISSN

2090-2581

Link

https://scumj.journals.ekb.eg/article_264318.html

Detail API

https://scumj.journals.ekb.eg/service?article_code=264318

Order

11

Type

Original Article

Type Code

938

Publication Type

Journal

Publication Title

Suez Canal University Medical Journal

Publication Link

https://scumj.journals.ekb.eg/

MainTitle

-

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Article

Created At

22 Jan 2023