Relation of intraventricular conduction delay to risk of new-onset heart failure and structural heart disease in the general population.
Bundle branch block
ECG
Heart failure
Intraventricular conduction delay
Population study
Structural heart disease
Journal
International journal of cardiology. Heart & vasculature
ISSN: 2352-9067
Titre abrégé: Int J Cardiol Heart Vasc
Pays: Ireland
ID NLM: 101649525
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
02
08
2020
revised:
07
09
2020
accepted:
10
09
2020
entrez:
5
10
2020
pubmed:
6
10
2020
medline:
6
10
2020
Statut:
epublish
Résumé
Intraventricular conduction delays (IVCDs) are hallmarks of heart failure (HF) and structural heart disease (SHD) but their prognostic value for HF and SHD is unclear. Relation of eight IVCDs and the incidence of first-time HF or SHD was studied in a nationally representative random sample of 6080 Finnish subjects aged ≥ 30 years (mean age 52.1, SD 14.5 years) who participated in the health examination including 12-lead ECG. During 16.5 years' follow up, half of the subjects with left bundle branch block (LBBB) and one third of the subjects with non-specific IVCD developed HF. After controlling for known clinical risk factors the hazard ratio (HR) for new-onset HF for LBBB was 3.29 (95% confidence interval 1.93-5.63, P < 0.001) and 3.53 for non-specific IVCD (1.65-7.55, P = 0.001). In corresponding analysis, LBBB predicted SHD with HR 2.60 (1.21-5.62, P = 0.015). Excluding subjects with history of heart disease, including coronary heart disease, did not have impact on results. Right bundle branch block and other IVCDs displayed no relation to endpoints. LBBB and non-specific IVCD were associated with more than three-fold risk of new-onset HF. Furthermore, LBBB was associated with novel SHD. Their presence should alert clinician even in subjects free from any known heart disease.
Sections du résumé
BACKGROUND
BACKGROUND
Intraventricular conduction delays (IVCDs) are hallmarks of heart failure (HF) and structural heart disease (SHD) but their prognostic value for HF and SHD is unclear.
METHODS
METHODS
Relation of eight IVCDs and the incidence of first-time HF or SHD was studied in a nationally representative random sample of 6080 Finnish subjects aged ≥ 30 years (mean age 52.1, SD 14.5 years) who participated in the health examination including 12-lead ECG.
RESULTS
RESULTS
During 16.5 years' follow up, half of the subjects with left bundle branch block (LBBB) and one third of the subjects with non-specific IVCD developed HF. After controlling for known clinical risk factors the hazard ratio (HR) for new-onset HF for LBBB was 3.29 (95% confidence interval 1.93-5.63, P < 0.001) and 3.53 for non-specific IVCD (1.65-7.55, P = 0.001). In corresponding analysis, LBBB predicted SHD with HR 2.60 (1.21-5.62, P = 0.015). Excluding subjects with history of heart disease, including coronary heart disease, did not have impact on results. Right bundle branch block and other IVCDs displayed no relation to endpoints.
CONCLUSION
CONCLUSIONS
LBBB and non-specific IVCD were associated with more than three-fold risk of new-onset HF. Furthermore, LBBB was associated with novel SHD. Their presence should alert clinician even in subjects free from any known heart disease.
Identifiants
pubmed: 33015317
doi: 10.1016/j.ijcha.2020.100639
pii: S2352-9067(20)30337-7
pmc: PMC7522339
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100639Informations de copyright
© 2020 The Author(s).
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
N Engl J Med. 2014 May 1;370(18):1694-701
pubmed: 24678999
Trends Cardiovasc Med. 2019 Aug;29(6):335-342
pubmed: 30401603
Indian Pacing Electrophysiol J. 2018 Nov - Dec;18(6):217-230
pubmed: 30326266
Eur Heart J. 2005 Nov;26(21):2300-6
pubmed: 16214833
Ann Med. 2015 Feb;47(1):74-80
pubmed: 25613171
J Am Coll Cardiol. 2005 Dec 20;46(12):2183-92
pubmed: 16360044
Heart. 2019 Aug;105(15):1160-1167
pubmed: 31129608
J Am Coll Cardiol. 2013 Mar 12;61(10):1089-95
pubmed: 23352778
Circ Heart Fail. 2013 Jul;6(4):655-61
pubmed: 23729198
Eur J Heart Fail. 2014 Oct;16(10):1073-81
pubmed: 25201219
N Engl J Med. 1994 Dec 8;331(23):1564-75
pubmed: 7969328
Br Heart J. 1980 Feb;43(2):164-9
pubmed: 6444828
JAMA. 2008 Jun 11;299(22):2656-66
pubmed: 18544725
Circulation. 2011 Mar 15;123(10):1061-72
pubmed: 21357819
Eur J Cardiovasc Prev Rehabil. 2005 Apr;12(2):132-7
pubmed: 15785298
Circulation. 1975 Mar;51(3):477-84
pubmed: 1132086
Eur Heart J. 2005 Jan;26(1):91-8
pubmed: 15615805
Am J Cardiol. 2018 Jul 15;122(2):199-205
pubmed: 29778237
Eur Heart J. 2013 Jan;34(2):138-46
pubmed: 22947613
Eur Heart J. 2013 Sep;34(33):2592-9
pubmed: 23641006
Circ Arrhythm Electrophysiol. 2011 Oct;4(5):704-10
pubmed: 21841194
Am Heart J. 2002 Mar;143(3):398-405
pubmed: 11868043
Am Heart J. 2010 Apr;159(4):593-8
pubmed: 20362717
J Am Coll Cardiol. 2013 Jun 18;61(24):2435-2443
pubmed: 23602768
JAMA. 2013 Apr 17;309(15):1587-8
pubmed: 23592102
Scand J Public Health. 2020 Feb;48(1):20-28
pubmed: 31068116
J Am Coll Cardiol. 1998 Jan;31(1):105-10
pubmed: 9426026
Am J Cardiol. 2011 Mar 15;107(6):927-34
pubmed: 21376930
Circulation. 1998 Dec 1;98(22):2494-500
pubmed: 9832497
Eur Heart J. 2009 Dec;30(23):2908-14
pubmed: 19687165
J Hypertens. 2016 May;34(5):959-66
pubmed: 26886566
Circ Heart Fail. 2015 Mar;8(2):243-51
pubmed: 25550439
Hypertension. 2006 May;47(5):861-7
pubmed: 16585411
Am J Cardiol. 2017 Dec 1;120(11):1990-1997
pubmed: 28958452
Am J Cardiol. 2006 Sep 1;98(5):644-8
pubmed: 16923453
BMJ. 1989 Jul 8;299(6691):81-5
pubmed: 2504340
Circulation. 2007 Mar 6;115(9):1154-63
pubmed: 17339573