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Prognostic Significance of Left Axis Deviation in Acute Heart Failure Patients with Left Bundle branch block: an Analysis from the Korean Acute Heart Failure (KorAHF) Registry

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Author(s)
Ki Hong ChoiSeongwook HanGa Yeon LeeJin-Oh ChoiEun-Seok JeonHae-Young LeeSang Eun LeeJae-Joong KimShung Chull ChaeSang Hong BaekSeok-Min KangDong-Ju ChoiByung-Su YooKye Hun KimMyeong-Chan ChoHyun-Young ParkByung-Hee Oh
Keimyung Author(s)
Han, Seong Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Circulation Journal
Issued Date
2018
Volume
48
Issue
11
Keyword
Bundle-branch blockHeart failureElectrocardiography
Abstract
Background and Objectives:
The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB.

Methods:
Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <−30 degree. The primary outcome was all-cause mortality.

Results:
The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, −3.25; 95% confidence interval, −5.82, −0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001).

Conclusions:
Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).
Keimyung Author(s)(Kor)
한성욱
Publisher
School of Medicine (의과대학)
Citation
Ki Hong Choi et al. (2018). Prognostic Significance of Left Axis Deviation in Acute Heart Failure Patients with Left Bundle branch block: an Analysis from the Korean Acute Heart Failure (KorAHF) Registry. Korean Circulation Journal, 48(11), 1002–1011. doi: 10.4070/kcj.2018.0048
Type
Article
ISSN
1738-5555
Source
https://e-kcj.org/DOIx.php?id=10.4070/kcj.2018.0048
DOI
10.4070/kcj.2018.0048
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41807
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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