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@article{1318869,
author = {Tolppanen, Heli and SiirilaandWaris, Krista and Harjola, VeliandPekka and Marono, David and Pařenica, Jiří and Kreutzinger, Philipp and Nieminen, Tuomo and Pavlušová, Marie and Tarvasmaki, Tuukka and Twerenbold, Raphael and Tolonen, Jukka and Miklik, Roman and Nieminen, Markku S. and Špinar, Jindřich and Mueller, Christian and Lassus, Johan},
article_location = {Biot},
article_number = {1},
doi = {http://dx.doi.org/10.1002/ehf2.12068},
keywords = {Acute heart failure; Ventricular conduction; Bundle branch block; Prognosis; de novo},
language = {eng},
issn = {2055-5822},
journal = {ESC Heart Failure},
title = {Ventricular conduction abnormalities as predictors of long-term survival in acute de novo and decompensated chronic heart failure},
volume = {3},
year = {2016}
}
TY - JOUR
ID - 1318869
AU - Tolppanen, Heli - Siirila-Waris, Krista - Harjola, Veli-Pekka - Marono, David - Pařenica, Jiří - Kreutzinger, Philipp - Nieminen, Tuomo - Pavlušová, Marie - Tarvasmaki, Tuukka - Twerenbold, Raphael - Tolonen, Jukka - Miklik, Roman - Nieminen, Markku S. - Špinar, Jindřich - Mueller, Christian - Lassus, Johan
PY - 2016
TI - Ventricular conduction abnormalities as predictors of long-term survival in acute de novo and decompensated chronic heart failure
JF - ESC Heart Failure
VL - 3
IS - 1
SP - 35-43
EP - 35-43
PB - John Wiley & Sons Ltd
SN - 20555822
KW - Acute heart failure
KW - Ventricular conduction
KW - Bundle branch block
KW - Prognosis
KW - de novo
N2 - Aims Data on the prognostic role of left and right bundle branch blocks (LBBB and RBBB), and nonspecific intraventricular conduction delay (IVCD; QRS 110 ms, no BBB) in acute heart failure (AHF) are controversial. Our aim was to investigate electrocardiographic predictors of long-term survival in patients with de novo AHF and acutely decompensated chronic heart failure (ADCHF). Methods and Results We analysed the admission electrocardiogram of 982 patients from a multicenter European cohort of AHF with 3.9 years’ mean follow-up. Half (51.5%, n = 506) of the patients had de novo AHF. LBBB, and IVCD were more common in ADCHF than in de novo AHF: 17.2% vs. 8.7% (P 0.001) and 20.6% vs. 13.2% (P = 0.001), respectively, and RBBB was almost equally common (6.9% and 8.1%; P = 0.5), respectively. Mortality during the follow-up was higher in patients with RBBB (85.4%) and IVCD (73.7%) compared with patients with normal ventricular conduction (57.0%); P<0.001 for both. The impact of RBBB on prognosis was prominent in de novo AHF (adjusted HR 1.93, 1.03–3.60; P = 0.04), and IVCD independently predicted death in ADCHF (adjusted HR 1.79, 1.28–2.52; P = 0.001). Both findings were pronounced in patients with reduced ejection fraction. LBBB showed no association with increased mortality in either of the subgroups. The main results were confirmed in a validation cohort of 1511 AHF patients with 5.9 years’ mean follow-up. Conclusions Conduction abnormalities predict long-term survival differently in de novo AHF and ADCHF. RBBB predicts mortality in de novo AHF, and IVCD in ADCHF. LBBB has no additive predictive value in AHF requiring hospitalization.
ER -
TOLPPANEN, Heli, Krista SIIRILA-WARIS, Veli-Pekka HARJOLA, David MARONO, Jiří PAŘENICA, Philipp KREUTZINGER, Tuomo NIEMINEN, Marie PAVLUŠOVÁ, Tuukka TARVASMAKI, Raphael TWERENBOLD, Jukka TOLONEN, Roman MIKLIK, Markku S. NIEMINEN, Jindřich ŠPINAR, Christian MUELLER a Johan LASSUS. Ventricular conduction abnormalities as predictors of long-term survival in acute de novo and decompensated chronic heart failure. \textit{ESC Heart Failure}. Biot: John Wiley \&{} Sons Ltd, 2016, roč.~3, č.~1, s.~35-43. ISSN~2055-5822. Dostupné z: https://dx.doi.org/10.1002/ehf2.12068.
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