Clinical and Prognostic Significance of Idiopathic Left Bundle-Branch Block in Young Adults
Aims. LBBB is rare in healthy young adults, and its long-term prognosis is uncertain. Methods. 56 subjects (aged <50 years), in whom an LBBB was discovered by chance in the absence of clinical and echocardiographic evidence of heart disease, were collected in a multicenter registry. Results. 69%...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/6677806 |
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| author | Pietro Delise Luigi Rivetti Giuseppe Poletti Monica Centa Giuseppe Allocca Nadir Sitta Arianna Cati Giovanni Turiano Emanuela Lanari Paolo Zeppilli Luigi Sciarra |
| author_facet | Pietro Delise Luigi Rivetti Giuseppe Poletti Monica Centa Giuseppe Allocca Nadir Sitta Arianna Cati Giovanni Turiano Emanuela Lanari Paolo Zeppilli Luigi Sciarra |
| author_sort | Pietro Delise |
| collection | DOAJ |
| description | Aims. LBBB is rare in healthy young adults, and its long-term prognosis is uncertain. Methods. 56 subjects (aged <50 years), in whom an LBBB was discovered by chance in the absence of clinical and echocardiographic evidence of heart disease, were collected in a multicenter registry. Results. 69% were males. Mean age at the time of discovery of LBBB was 37 ± 11 years. Mean QRS duration was 149 ± 17 m sec and 35% had left axis deviation. All patients had a normal echocardiogram, except for left ventricular dyssynchrony; 37 patients underwent coronary angiography (30) or myocardial scintigraphy during effort Eriksson and Wilhelmsen (2005), and in all cases obstructive coronary artery disease was excluded. In 2/30 patients who underwent coronary angiography, an anomalous origin of the CX artery from the right coronary sinus was found. Thirty patients underwent cardiac magnetic resonance; in 60% it was normal, while in 40% it revealed late enhancement, which in 33% was localized in the basal septum, suggesting fibrosis of the left bundle branch. During follow-up (12+/10 years, median 10 years) no sudden death occurred. At the end of follow-up, all patients were alive, except for one who suffered accidental death. Two patients (3.5%) underwent PM implantation owing to syncope. The echocardiogram at the end of follow-up revealed LV dysfunction in only one patient. Conclusions. In young adults without apparent heart disease, LBBB is a heterogeneous condition. In the vast majority of cases, the prognosis is good and no ventricular dysfunction occurs over time. However, as only 18% of our patients were aged >60 years at the end of follow-up, we cannot establish the prognosis in older age-groups. |
| format | Article |
| id | doaj-art-52d57104ce1d438b84b8041e1b156486 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-52d57104ce1d438b84b8041e1b1564862025-02-03T06:07:39ZengWileyCardiology Research and Practice2090-80162090-05972021-01-01202110.1155/2021/66778066677806Clinical and Prognostic Significance of Idiopathic Left Bundle-Branch Block in Young AdultsPietro Delise0Luigi Rivetti1Giuseppe Poletti2Monica Centa3Giuseppe Allocca4Nadir Sitta5Arianna Cati6Giovanni Turiano7Emanuela Lanari8Paolo Zeppilli9Luigi Sciarra10Division of Cardiology, P. Pederzoli Hospital, Peschiera Del Garda, ItalyDivision of Cardiology, Conegliano Hospital, Conegliano, TV, ItalyStudio Poletti, Bologna, ItalyDivision of Cardiology, Conegliano Hospital, Conegliano, TV, ItalyDivision of Cardiology, Conegliano Hospital, Conegliano, TV, ItalyDivision of Cardiology, Conegliano Hospital, Conegliano, TV, ItalyDivision of Cardiology, Conegliano Hospital, Conegliano, TV, ItalyDivision of Cardiology, Hospital of S. Donà di Piave, S. Donà di Piave, ItalyDivision of Cardiology, Conegliano Hospital, Conegliano, TV, ItalySacred Heart Hospital, Rome, ItalyCasilino Hospital, Rome, ItalyAims. LBBB is rare in healthy young adults, and its long-term prognosis is uncertain. Methods. 56 subjects (aged <50 years), in whom an LBBB was discovered by chance in the absence of clinical and echocardiographic evidence of heart disease, were collected in a multicenter registry. Results. 69% were males. Mean age at the time of discovery of LBBB was 37 ± 11 years. Mean QRS duration was 149 ± 17 m sec and 35% had left axis deviation. All patients had a normal echocardiogram, except for left ventricular dyssynchrony; 37 patients underwent coronary angiography (30) or myocardial scintigraphy during effort Eriksson and Wilhelmsen (2005), and in all cases obstructive coronary artery disease was excluded. In 2/30 patients who underwent coronary angiography, an anomalous origin of the CX artery from the right coronary sinus was found. Thirty patients underwent cardiac magnetic resonance; in 60% it was normal, while in 40% it revealed late enhancement, which in 33% was localized in the basal septum, suggesting fibrosis of the left bundle branch. During follow-up (12+/10 years, median 10 years) no sudden death occurred. At the end of follow-up, all patients were alive, except for one who suffered accidental death. Two patients (3.5%) underwent PM implantation owing to syncope. The echocardiogram at the end of follow-up revealed LV dysfunction in only one patient. Conclusions. In young adults without apparent heart disease, LBBB is a heterogeneous condition. In the vast majority of cases, the prognosis is good and no ventricular dysfunction occurs over time. However, as only 18% of our patients were aged >60 years at the end of follow-up, we cannot establish the prognosis in older age-groups.http://dx.doi.org/10.1155/2021/6677806 |
| spellingShingle | Pietro Delise Luigi Rivetti Giuseppe Poletti Monica Centa Giuseppe Allocca Nadir Sitta Arianna Cati Giovanni Turiano Emanuela Lanari Paolo Zeppilli Luigi Sciarra Clinical and Prognostic Significance of Idiopathic Left Bundle-Branch Block in Young Adults Cardiology Research and Practice |
| title | Clinical and Prognostic Significance of Idiopathic Left Bundle-Branch Block in Young Adults |
| title_full | Clinical and Prognostic Significance of Idiopathic Left Bundle-Branch Block in Young Adults |
| title_fullStr | Clinical and Prognostic Significance of Idiopathic Left Bundle-Branch Block in Young Adults |
| title_full_unstemmed | Clinical and Prognostic Significance of Idiopathic Left Bundle-Branch Block in Young Adults |
| title_short | Clinical and Prognostic Significance of Idiopathic Left Bundle-Branch Block in Young Adults |
| title_sort | clinical and prognostic significance of idiopathic left bundle branch block in young adults |
| url | http://dx.doi.org/10.1155/2021/6677806 |
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