Cumulative effect of complete left bundle-branch block and chronic atrial fibrillation on 1-year mortality and hospitalization in patients with congestive heart failure - A report from the Italian network on congestive heart failure (in-CHF database)

被引：53

作者：

Baidasseroni, S

De Biase, L

Fresco, C

Marchionni, N

Marini, M

Masotti, G

Orsini, G

Porcu, M

Pozzar, F

Scherillo, M

Maggioni, AP

机构：

[1] Italian Assoc Hosp Cardiologists, ANMCO Res Ctr, I-50121 Florence, Italy

[2] S Andrea Hosp, Dept Cardiol, Rome, Italy

[3] Osped S Maria Misericordia, Dept Cardiol, Udine, Italy

[4] Univ Florence, Azienda Osped Gareggi, Dept Crit Care Med & Surg, Florence, Italy

[5] S Michele Brotzu Hosp, Dept Cardiol, Cagliari, Italy

[6] San Camillo Hosp, Dept Cardiol, Rome, Italy

[7] Monaldi Hosp, Dept Cardiol, Naples, Italy

来源：

EUROPEAN HEART JOURNAL | 2002年 / 23卷 / 21期

关键词：

congestive heart failure; atrial fibrillation; complete left bundle branch-block; prognosis;

D O I：

10.1053/euhj.2001.3157

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Many clinical variables have been proposed as prognostic factors in patients with congestive heart failure. Among these, complete left bundle-branch block and atrial fibrillation are known to impair significantly left ventricular performance in patients with congestive heart failure. However, their combined effect on mortality has been poorly investigated. The aim of this study was to determine whether left bundle-branch block associated with atrial fibrillation had an independent, cumulative effect on mortality for congestive heart failure. Methods and Results We analysed the Italian Network on congestive heart failure (IN-CHF) Registry that was established by the Italian Association of Hospital Cardiologists in 1995. One-year follow-up data were available for 5517 patients. Complete left bundle-branch block and atrial fibrillation were associated in 185 (3.3%) patients. In this population the cause of congestive heart failure was dilated cardiomyopathy (38.4%), ischaemic heart disease (35.1%.), hypertensive heart disease (17.3%), and other aetiologies (9.2%). This combination of electrical defects was associated with an increased 1-year mortality from any cause (hazard ratio, HR: 1.88; 95% CI 1.37-2.57) and sudden death (HR: 1.89; 95% CI 1.17-3.03) and 1-year hospitalization rate (HR: 1.83; 95% CI 1.26-2.67). Conclusions In patients with congestive heart failure, the contemporary presence of left bundle-branch block and atrial fibrillation was associated with a significant increase in mortality. This synergistic effect remained significant after adjusting for clinical variables usually associated with advanced heart failure. We can conclude that this combination of electrical disturbances identifies a congestive heart failure specific population with a high risk of mortality.

引用

页码：1692 / 1698

页数：7

共 31 条

[1]

Auricchio A, 1999, AM J CARDIOL, V83, p130D

[2]

Baldasseroni S, 2001, J AM COLL CARDIOL, V37, p156A

[3] Mild systolic dysfunction in heart failure (left ventricular ejection fraction >35%): Baseline characteristics, prognosis and response to therapy in the vasodilator in heart failure trials (V-HeFT) [J].