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논문 기본 정보

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학술저널
저자정보
Ki Hong Choi (Sungkyunkwan University School of Medicine) Seongwook Han (Keimyung University Dongsan Medical Center) Ga Yeon Lee (Sungkyunkwan University School of Medicine) Jin-Oh Choi (Sungkyunkwan University School of Medicine) Eun-Seok Jeon (Sungkyunkwan University School of Medicine) Hae-Young Lee (Seoul National University Hospital) Sang Eun Lee (Seoul National University Hospital) Jae-Joong Kim (University of Ulsan College of Medicine) Shung Chull Chae (Kyungpook National University College of Medicine) Sang Hong Baek (The Catholic University of Korea) Seok-Min Kang (Yonsei University College of Medicine) Dong-Ju Choi (Seoul National University Bundang Hospital) Byung-Su Yoo (Yonsei University Wonju College of Medicine) Kye Hun Kim (Heart Research Center of Chonnam National University) Myeong-Chan Cho (Chungbuk National University College of Medicine) Hyun-Young Park (National Institute of Health (NIH)) Byung-Hee Oh (Keimyung University Dongsan Medical Center)
저널정보
대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.48 No.11
발행연도
2018.1
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1,002 - 1,011 (10page)

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Background and Objectives: The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB)is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods: Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <−30 degree. The primary outcome was all-cause mortality. Results: The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, −3.25; 95% confidence interval, −5.82, −0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).

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참고문헌 (28)

참고문헌 신청
Baldasseroni S / 2002 / Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure : a report from the Italian network on congestive heart failure / Am Heart J 143:398~405 google schola Ponikowski P / 2016 / 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure : The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology(ESC)Developed with the special contribution of the Heart Failure Association(HFA)of the ESC / Eur Heart J 37:2129~2200 google schola Bristow MR / 2004 / Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure / N Engl J Med 350:2140~2150 google schola Zusterzeel R / 2014 / Cardiac resynchronization therapy in women : US Food and Drug Administration meta-analysis of patient-level data / JAMA Intern Med 174:1340~1348 google schola Zareba W / 2011 / Effectiveness of cardiac resynchronization therapy by QRS morphology in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy(MADIT-CRT) / Circulation 123:1061~1072 google schola

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