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Association of Newly Developed Right Bundle Branch Block with Graft Rejection Following Heart Transplantation

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Author(s)
Jin-Ho KimJaewon OhMin Ji KimIn-Cheol KimJae-Sun UhmHui-Nam PakSeok-Min Kang
Keimyung Author(s)
Kim, In Cheol
Department
Dept. of Internal Medicine (내과학)
Journal Title
Yonsei Medical Journal
Issued Date
2019
Volume
60
Issue
5
Keyword
Right bundle branch blockheart transplantationrejection
Abstract
Purpose:
We aimed to examine associations between right bundle branch block (RBBB) following heart transplantation (HT) and graft rejection.

Materials and Methods:
We investigated 51 patients who underwent endomyocardial biopsies, electrocardiogram, right-side cardiac catheterization, and echocardiography at 1 month and 1 year after HT. We classified patients into four groups according to the development of RBBB, based on electrocardiogram at 1 month and 1 year: 1) sustained RBBB, 2) disappeared RBBB, 3) newly developed RBBB, and 4) sustained non-RBBB. The RBBB was defined as an RSR' pattern in V1 with a QRS duration ≥100 ms on electrocardiogram.

Results:
The newly developed RBBB group (n=13, 25.5%) had a higher rate of new onset graft rejection (from grade 0 to grade ≥1R, 30.8% vs. 10.0% vs. 21.4%, p=0.042) at 1 year, compared with sustained RBBB (n=10, 19.6%) and sustained non-RBBB group (n=28, 54.9%). In contrast, the incidence of resolved graft rejection (from grade ≥1R to grade 0) was higher in the sustained RBBB group than the newly developed RBBB and sustained non-RBBB groups (70.0% vs. 7.7% vs. 25.0%, p=0.042). Left atrial volume index was significantly higher in the newly developed RBBB group than the sustained RBBB and sustained non-RBBB groups (60.6±25.9 mL/m2 vs. 36.0±11.0 mL/m2 vs. 38.4±18.1 mL/m2, p=0.003).

Conclusion:
Close monitoring for new development of RBBB at 1 year after HT, which was associated with a higher incidence of new onset graft rejection, may be helpful to identify high risk patients for graft rejection.
Keimyung Author(s)(Kor)
김인철
Publisher
School of Medicine (의과대학)
Citation
Jin-Ho Kim et al. (2019). Association of Newly Developed Right Bundle Branch Block with Graft Rejection Following Heart Transplantation. Yonsei Medical Journal, 60(5), 423–428. doi: 10.3349/ymj.2019.60.5.423
Type
Article
ISSN
1976-2437
Source
https://www.eymj.org/DOIx.php?id=10.3349/ymj.2019.60.5.423
DOI
10.3349/ymj.2019.60.5.423
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41993
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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