Of the 1317 enrolled patients, 23 patients with missing electrocardiograph test results and 175 patients with various secondary cardiomyopathies were excluded from the study. We measured the following DCM exclusion criteria : systemic hypertension (>160/100 mmHg), coronary artery disease (>50 % in one or more major branches), chronic excess alcohol consumption (>40 g/day for females, > 80 g/day for males for more than five years after 6 months of abstinence), systemic diseases known to cause IDC, pericardial diseases, congenital heart disease, cor pulmonale, and rapid, sustained supraventricular tachycardia. The patients were admitted due to their decompensation symptoms and the physical signs of heart failure, and DCM was defined as systolic dysfunction with LV dilation in the absence of an apparent secondary cause of cardiomyopathy. VCB (LBBB, RBBB, IVCD) were identified from records of individual 12-lead ECGs in 1317 patients (Fig. This study was a retrospective, observational cohort study of patients with DCM observed from November 2003 to September 2011. Therefore, in the present study, we evaluated the association of VCB patterns and all-cause mortality and compared the prognostic values of RBBB, LBBB, and IVCD in hospitalized patients with DCM. The prognostic implications of VCB in the long-term mortality of patients with DCM merit examination due to the lack of data on this issue. These patients also have worse clinical outcomes. Patients with intraventricular conduction delays (IVCDs) can also present with DCM, often without specifying the particular type of BBB. Conversely, two studies recently showed that RBBB but not LBBB is associated with an increased 1-year and 4-year mortality risk in hospitalized patients with HF. Most studies indicate that left BBB (LBBB) is an independent prognostic marker, whereas right BBB (RBBB) is a weaker marker or not associated with a worse prognosis. There is controversy regarding the type of bundle branch block (BBB) that is associated with poorer outcomes in patients with heart failure (HF).
Patients with DCM present with an increase in the QRS duration in the presence of a ventricular conduction block (VCB). However, the clinical spectrum is wide, and it is difficult for physicians to predict which clinical course an individual patient may follow. The prognosis in patients with DCM is poor. Our findings indicate that RBBB and IVCD at admission,but not LBBB, were independent predictors of all-cause mortality in patients with DCM.ĭilated cardiomyopathy (DCM), a leading cause of heart failure and arrhythmia, is a disease of the heart muscle characterized by ventricular dilation and impaired systolic function. The presence of RBBB, IVCD, PASP ≥ 40 mmHg, left atrium diameter and NYHA functional class were independent predictors of all-cause mortality in DCM patients.
The all-cause mortality risk was significantly different between the VCB and narrow QRS group (log-rank χ2 = 51.564, P < 0.001). Of those 1119 patients, the all-cause mortality rates were highest in patients with IVCD (47.8, n = 32), intermediate in those with RBBB (32.9, n = 27) and LBBB (27.1 %, n = 60), and lowest in those with narrow QRS (19.9 %, n = 149).
The all-cause mortality was assessed using Kaplan-Meier survival curves and Cox regression. This cohort study included 1119 DCM patients with a median follow-up of 34.3 (19.5–60.8) months, patients were then divided into left bundle branch block (LBBB), right bundle branch block (RBBB), intraventricular conduction delays (IVCD) and narrow QRS groups. The purpose of this study was to determine all-cause mortality in patients with DCM and VCB. However, the prognostic implications of VCB patterns in dilated cardiomyopathy (DCM) patients need to be evaluated. Ventricular conduction blocks (VCBs) are associated with poor outcomes in patients with known cardiac diseases.
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