Prevalence and Long-Term Prognosis of Patients with Complete Bundle Branch Block (Right or Left Bundle Branch) with Normal Left Ventricular Ejection Fraction Referred for Stress Echocardiography
Background The prognostic value of stress echocardiography (SE) in patients with complete bundle branch blocks (BBB) with normal left ventricular ejection fraction (LVEF) has not been well described. We sought to determine the prognostic value of SE in patients with BBB and normal LVEF. Methods We a...
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| Veröffentlicht in: | Echocardiography (Mount Kisco, N.Y.) N.Y.), 2015-03, Vol.32 (3), p.483-489 |
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| creator | Supariwala, Azhar A. Po, Jose Ricardo F. Mohareb, Sameh Aslam, Farhan Kaddaha, Firas Mian, Zainab I. Chaudhry, Farhan Otokiti, Ahmed Chaudhry, Farooq A. |
| description | Background
The prognostic value of stress echocardiography (SE) in patients with complete bundle branch blocks (BBB) with normal left ventricular ejection fraction (LVEF) has not been well described. We sought to determine the prognostic value of SE in patients with BBB and normal LVEF.
Methods
We analyzed 7214 patients (58 ± 14 years; 57% female) with a mean follow‐up time of 9 ± 4 years. Dobutamine SE was performed in 51% of patients and exercise SE was performed in 49%. All‐cause mortality data were obtained from the Social Security Death Index.
Results
There were 222 (3%) patients with right bundle branch block (RBBB) and 50 (0.7%) patients with left bundle branch block (LBBB). Patients with LBBB were 3 times more likely to have an abnormal stress test after adjusting for age, gender, mode of stress test, and coronary artery disease risk factors (OR = 3.3; 95% CI: 1.86–5.92; P |
| doi_str_mv | 10.1111/echo.12680 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1660928089</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1660928089</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3670-60b2f53fd5706015578b5f313d631eb3c14f0dc4fec1e3f0699a50702eeff9e83</originalsourceid><addsrcrecordid>eNp9kc1uEzEURi0EoqGw4QGQlwVpyvV4PD9LGiUtIkqjUGBpOZ7rxO3MOLU9lLweT8aUaSux4W7ulXy-I1kfIW8ZnLJhPqLeuVOW5iU8IxMmMkhKVojnZAJFliZpmaZH5FUI1wBQMJa9JEepAF7xQkzI75XHn6rBTiNVXU0XrtsmV-hbuvJu27lgA3WGrlS02MVA72zc0alr9w1GpGd9VzfD8qrTO3rWOH1DT9Z2u4vUebpAE_9F3o_5pfOtasb374PWW903ytPZNepoXUfnXo3HGg16jzU1g-9r9BgCnQ3f1crX1m292u8Or8kLo5qAbx72Mfk2n11NL5LF5fnn6adFonleQJLDJjWCm1oUkAMToig3wnDG65wz3HDNMgO1zgxqhtxAXlVKQAEpojEVlvyYnIzevXe3PYYoWxs0No3q0PVBsjyHKi2hrAb0w4hq70LwaOTe21b5g2Qg7zuT953Jv50N8LsHb79psX5CH0saADYCd7bBw39Ucja9uHyUJmPGhoi_njLK38i8GKTyx_JcfsnYGkq2lHP-B_H6sxM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1660928089</pqid></control><display><type>article</type><title>Prevalence and Long-Term Prognosis of Patients with Complete Bundle Branch Block (Right or Left Bundle Branch) with Normal Left Ventricular Ejection Fraction Referred for Stress Echocardiography</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Supariwala, Azhar A. ; Po, Jose Ricardo F. ; Mohareb, Sameh ; Aslam, Farhan ; Kaddaha, Firas ; Mian, Zainab I. ; Chaudhry, Farhan ; Otokiti, Ahmed ; Chaudhry, Farooq A.</creator><creatorcontrib>Supariwala, Azhar A. ; Po, Jose Ricardo F. ; Mohareb, Sameh ; Aslam, Farhan ; Kaddaha, Firas ; Mian, Zainab I. ; Chaudhry, Farhan ; Otokiti, Ahmed ; Chaudhry, Farooq A.</creatorcontrib><description>Background
The prognostic value of stress echocardiography (SE) in patients with complete bundle branch blocks (BBB) with normal left ventricular ejection fraction (LVEF) has not been well described. We sought to determine the prognostic value of SE in patients with BBB and normal LVEF.
Methods
We analyzed 7214 patients (58 ± 14 years; 57% female) with a mean follow‐up time of 9 ± 4 years. Dobutamine SE was performed in 51% of patients and exercise SE was performed in 49%. All‐cause mortality data were obtained from the Social Security Death Index.
Results
There were 222 (3%) patients with right bundle branch block (RBBB) and 50 (0.7%) patients with left bundle branch block (LBBB). Patients with LBBB were 3 times more likely to have an abnormal stress test after adjusting for age, gender, mode of stress test, and coronary artery disease risk factors (OR = 3.3; 95% CI: 1.86–5.92; P < 0.001). The mortality rates were 4.5%/year for patients with LBBB, 2.5%/year for patients with RBBB, and 1.9%/year for patients without BBB (P < 0.001). Among patients with a normal SE, those with LBBB had similar mortality to those without LBBB (HR = 0.9; 95% CI: 0.4–2.2; P = 0.8). Patients with LBBB and abnormal SE had more than 2 times greater risk of all‐cause mortality (HR = 2.4; 95% CI: 1.4–4.2; P = 0.002).
Conclusion
A normal stress echocardiogram in LBBB is associated with benign prognosis while those with LBBB and abnormal SE have the worst outcomes.</description><identifier>ISSN: 0742-2822</identifier><identifier>EISSN: 1540-8175</identifier><identifier>DOI: 10.1111/echo.12680</identifier><identifier>PMID: 25039375</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Aged ; Bundle-Branch Block - epidemiology ; Bundle-Branch Block - mortality ; Dobutamine ; Echocardiography, Stress - statistics & numerical data ; Exercise Test - statistics & numerical data ; Female ; Humans ; left bundle branch block ; Longitudinal Studies ; Male ; Middle Aged ; New York - epidemiology ; Prevalence ; Prognosis ; Reproducibility of Results ; right bundle branch block ; Risk Assessment ; Sensitivity and Specificity ; stress echocardiography ; survival ; Survival Rate ; Vasodilator Agents</subject><ispartof>Echocardiography (Mount Kisco, N.Y.), 2015-03, Vol.32 (3), p.483-489</ispartof><rights>2014, Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3670-60b2f53fd5706015578b5f313d631eb3c14f0dc4fec1e3f0699a50702eeff9e83</citedby><cites>FETCH-LOGICAL-c3670-60b2f53fd5706015578b5f313d631eb3c14f0dc4fec1e3f0699a50702eeff9e83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fecho.12680$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fecho.12680$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25039375$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Supariwala, Azhar A.</creatorcontrib><creatorcontrib>Po, Jose Ricardo F.</creatorcontrib><creatorcontrib>Mohareb, Sameh</creatorcontrib><creatorcontrib>Aslam, Farhan</creatorcontrib><creatorcontrib>Kaddaha, Firas</creatorcontrib><creatorcontrib>Mian, Zainab I.</creatorcontrib><creatorcontrib>Chaudhry, Farhan</creatorcontrib><creatorcontrib>Otokiti, Ahmed</creatorcontrib><creatorcontrib>Chaudhry, Farooq A.</creatorcontrib><title>Prevalence and Long-Term Prognosis of Patients with Complete Bundle Branch Block (Right or Left Bundle Branch) with Normal Left Ventricular Ejection Fraction Referred for Stress Echocardiography</title><title>Echocardiography (Mount Kisco, N.Y.)</title><addtitle>Echocardiography</addtitle><description>Background
The prognostic value of stress echocardiography (SE) in patients with complete bundle branch blocks (BBB) with normal left ventricular ejection fraction (LVEF) has not been well described. We sought to determine the prognostic value of SE in patients with BBB and normal LVEF.
Methods
We analyzed 7214 patients (58 ± 14 years; 57% female) with a mean follow‐up time of 9 ± 4 years. Dobutamine SE was performed in 51% of patients and exercise SE was performed in 49%. All‐cause mortality data were obtained from the Social Security Death Index.
Results
There were 222 (3%) patients with right bundle branch block (RBBB) and 50 (0.7%) patients with left bundle branch block (LBBB). Patients with LBBB were 3 times more likely to have an abnormal stress test after adjusting for age, gender, mode of stress test, and coronary artery disease risk factors (OR = 3.3; 95% CI: 1.86–5.92; P < 0.001). The mortality rates were 4.5%/year for patients with LBBB, 2.5%/year for patients with RBBB, and 1.9%/year for patients without BBB (P < 0.001). Among patients with a normal SE, those with LBBB had similar mortality to those without LBBB (HR = 0.9; 95% CI: 0.4–2.2; P = 0.8). Patients with LBBB and abnormal SE had more than 2 times greater risk of all‐cause mortality (HR = 2.4; 95% CI: 1.4–4.2; P = 0.002).
Conclusion
A normal stress echocardiogram in LBBB is associated with benign prognosis while those with LBBB and abnormal SE have the worst outcomes.</description><subject>Aged</subject><subject>Bundle-Branch Block - epidemiology</subject><subject>Bundle-Branch Block - mortality</subject><subject>Dobutamine</subject><subject>Echocardiography, Stress - statistics & numerical data</subject><subject>Exercise Test - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>left bundle branch block</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>New York - epidemiology</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>right bundle branch block</subject><subject>Risk Assessment</subject><subject>Sensitivity and Specificity</subject><subject>stress echocardiography</subject><subject>survival</subject><subject>Survival Rate</subject><subject>Vasodilator Agents</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1uEzEURi0EoqGw4QGQlwVpyvV4PD9LGiUtIkqjUGBpOZ7rxO3MOLU9lLweT8aUaSux4W7ulXy-I1kfIW8ZnLJhPqLeuVOW5iU8IxMmMkhKVojnZAJFliZpmaZH5FUI1wBQMJa9JEepAF7xQkzI75XHn6rBTiNVXU0XrtsmV-hbuvJu27lgA3WGrlS02MVA72zc0alr9w1GpGd9VzfD8qrTO3rWOH1DT9Z2u4vUebpAE_9F3o_5pfOtasb374PWW903ytPZNepoXUfnXo3HGg16jzU1g-9r9BgCnQ3f1crX1m292u8Or8kLo5qAbx72Mfk2n11NL5LF5fnn6adFonleQJLDJjWCm1oUkAMToig3wnDG65wz3HDNMgO1zgxqhtxAXlVKQAEpojEVlvyYnIzevXe3PYYoWxs0No3q0PVBsjyHKi2hrAb0w4hq70LwaOTe21b5g2Qg7zuT953Jv50N8LsHb79psX5CH0saADYCd7bBw39Ucja9uHyUJmPGhoi_njLK38i8GKTyx_JcfsnYGkq2lHP-B_H6sxM</recordid><startdate>201503</startdate><enddate>201503</enddate><creator>Supariwala, Azhar A.</creator><creator>Po, Jose Ricardo F.</creator><creator>Mohareb, Sameh</creator><creator>Aslam, Farhan</creator><creator>Kaddaha, Firas</creator><creator>Mian, Zainab I.</creator><creator>Chaudhry, Farhan</creator><creator>Otokiti, Ahmed</creator><creator>Chaudhry, Farooq A.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201503</creationdate><title>Prevalence and Long-Term Prognosis of Patients with Complete Bundle Branch Block (Right or Left Bundle Branch) with Normal Left Ventricular Ejection Fraction Referred for Stress Echocardiography</title><author>Supariwala, Azhar A. ; Po, Jose Ricardo F. ; Mohareb, Sameh ; Aslam, Farhan ; Kaddaha, Firas ; Mian, Zainab I. ; Chaudhry, Farhan ; Otokiti, Ahmed ; Chaudhry, Farooq A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3670-60b2f53fd5706015578b5f313d631eb3c14f0dc4fec1e3f0699a50702eeff9e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Bundle-Branch Block - epidemiology</topic><topic>Bundle-Branch Block - mortality</topic><topic>Dobutamine</topic><topic>Echocardiography, Stress - statistics & numerical data</topic><topic>Exercise Test - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>left bundle branch block</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>New York - epidemiology</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>right bundle branch block</topic><topic>Risk Assessment</topic><topic>Sensitivity and Specificity</topic><topic>stress echocardiography</topic><topic>survival</topic><topic>Survival Rate</topic><topic>Vasodilator Agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Supariwala, Azhar A.</creatorcontrib><creatorcontrib>Po, Jose Ricardo F.</creatorcontrib><creatorcontrib>Mohareb, Sameh</creatorcontrib><creatorcontrib>Aslam, Farhan</creatorcontrib><creatorcontrib>Kaddaha, Firas</creatorcontrib><creatorcontrib>Mian, Zainab I.</creatorcontrib><creatorcontrib>Chaudhry, Farhan</creatorcontrib><creatorcontrib>Otokiti, Ahmed</creatorcontrib><creatorcontrib>Chaudhry, Farooq A.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Supariwala, Azhar A.</au><au>Po, Jose Ricardo F.</au><au>Mohareb, Sameh</au><au>Aslam, Farhan</au><au>Kaddaha, Firas</au><au>Mian, Zainab I.</au><au>Chaudhry, Farhan</au><au>Otokiti, Ahmed</au><au>Chaudhry, Farooq A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and Long-Term Prognosis of Patients with Complete Bundle Branch Block (Right or Left Bundle Branch) with Normal Left Ventricular Ejection Fraction Referred for Stress Echocardiography</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2015-03</date><risdate>2015</risdate><volume>32</volume><issue>3</issue><spage>483</spage><epage>489</epage><pages>483-489</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract>Background
The prognostic value of stress echocardiography (SE) in patients with complete bundle branch blocks (BBB) with normal left ventricular ejection fraction (LVEF) has not been well described. We sought to determine the prognostic value of SE in patients with BBB and normal LVEF.
Methods
We analyzed 7214 patients (58 ± 14 years; 57% female) with a mean follow‐up time of 9 ± 4 years. Dobutamine SE was performed in 51% of patients and exercise SE was performed in 49%. All‐cause mortality data were obtained from the Social Security Death Index.
Results
There were 222 (3%) patients with right bundle branch block (RBBB) and 50 (0.7%) patients with left bundle branch block (LBBB). Patients with LBBB were 3 times more likely to have an abnormal stress test after adjusting for age, gender, mode of stress test, and coronary artery disease risk factors (OR = 3.3; 95% CI: 1.86–5.92; P < 0.001). The mortality rates were 4.5%/year for patients with LBBB, 2.5%/year for patients with RBBB, and 1.9%/year for patients without BBB (P < 0.001). Among patients with a normal SE, those with LBBB had similar mortality to those without LBBB (HR = 0.9; 95% CI: 0.4–2.2; P = 0.8). Patients with LBBB and abnormal SE had more than 2 times greater risk of all‐cause mortality (HR = 2.4; 95% CI: 1.4–4.2; P = 0.002).
Conclusion
A normal stress echocardiogram in LBBB is associated with benign prognosis while those with LBBB and abnormal SE have the worst outcomes.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>25039375</pmid><doi>10.1111/echo.12680</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 0742-2822 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Bundle-Branch Block - epidemiology Bundle-Branch Block - mortality Dobutamine Echocardiography, Stress - statistics & numerical data Exercise Test - statistics & numerical data Female Humans left bundle branch block Longitudinal Studies Male Middle Aged New York - epidemiology Prevalence Prognosis Reproducibility of Results right bundle branch block Risk Assessment Sensitivity and Specificity stress echocardiography survival Survival Rate Vasodilator Agents |
| title | Prevalence and Long-Term Prognosis of Patients with Complete Bundle Branch Block (Right or Left Bundle Branch) with Normal Left Ventricular Ejection Fraction Referred for Stress Echocardiography |
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