Diagnostic and prognostic value of left bundle branch block and its correlation with left ventricular functions: a prospective observational study

Bharath M. S., Sunayana N. S., Channakeshava S. P.


Background: Left bundle branch block (LBBB) indicates organic heart disease. It is commonly associated with ischemic heart disease (IHD), cardiomyopathies, intrinsic disease of conduction system, hypertensive heart disease and acute myocardial infarction can present as new onset LBBB. Purpose of the study was to find out the etiology, outcome in patients having LBBB with respect to left ventricular function coming to our hospital.

Methods: All patients coming to our hospital as inpatient or outpatient basis with ECG suggestive of LBBB were studied. Their detailed history was taken and examination was done. 2D-Echocardiography (2D ECHO) was done in all patients and coronary angiogram (CAG) when indicated.

Results: Total of 116 patients who had LBBB were studied. Mean age was 62.25±13.75 years. 62 of them were male (53.45%) and 54 were female (46.55%). On presentation 41 patients had dyspnea (35.34%) and 37 had chest pain (31.89%). 24 patients were asymptomatic (20.68%). 59 patients had hypertension (50.86%) and 35 patients had diabetes (30.17%). On 2D ECHO, 39 patients (33.6%) had left ventricular hypertrophy (LVH), with 29 having diastolic and 10 systolic dysfunctions. 26 patients (22.41%) had dilated cardiomyopathy (DCM) and 30 patients had evidence of myocardial infarction (25.86%). 17 patients had normal echocardiography (14.05%). In total 62 patients had systolic dysfunction (53.44%).

Conclusions: Commonest clinical presentation was dyspnoea followed by chest pain in patients with LBBB. Most of them had hypertension. LVH was the commonest 2D ECHO finding followed by global hypokinesia and regional wall motion abnormality. Ventricular systolic dysfunction was present in more than 50% patients. CAG revealed coronary artery diseases in majority of cases in whom CAG was indicated.



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