Prolonged QRS duration (QRS ≥ 170 ms) and left axis deviation in the presence of left bundle branch block

A marker of poor left ventricular systolic function?

Mithilesh Das, Kuruvilla Cheriparambil, Ashwini Bedi, John Kassotis, Chatla V R Reddy, Majesh Makan, Christopher C. Dunbar, Barry Saul

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: Left bundle branch block (LBBB) is commonly associated with structural heart disease and left ventricular dysfunction. We propose that the QRS duration and degree of left-axis deviation (LAD) identify significant left ventricular systolic dysfunction in patients with LBBB. Methods: In this prospective study the ejection fraction (EF) of 300 consecutive patients with LBBB was evaluated by echocardiography. The relationship between QRS duration and LAD (axis between -30°and -90°) and EF were derived. Results: There was no significant difference in age, sex, presence of ischemic or nonischemic cardiomyopathy and valvular heart disease, and EF among the patients with or without LAD. The EF of patients with QRS ≥170 milliseconds with LAD (n = 20) and without LAD (n = 18) was 25% ± 16% and 23% ± 13%, respectively (P = .71). The mean EF (24% ± 10%) of the patients with a QRS duration of ≥170 milliseconds (n = 38) was significantly lower than the mean EF (36% ± 16%) of the patients with a QRS duration of 2 = 0.13, SE of estimate = 16.21). However, the QRS axis was not significantly correlated with EF and did not have added predictive value. Conclusions: The QRS duration has a significant inverse relationship with EF and prolongation of QRS duration (≥170 milliseconds) in the presence of LBBB is a marker of significant left ventricular systolic dysfunction. The presence of LAD in LBBB does not signify a further decrease in EF.

Original languageEnglish (US)
Pages (from-to)756-759
Number of pages4
JournalAmerican Heart Journal
Volume142
Issue number5
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Bundle-Branch Block
Left Ventricular Function
Left Ventricular Dysfunction
Heart Valve Diseases
Cardiomyopathies
Echocardiography
Heart Diseases
Prospective Studies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prolonged QRS duration (QRS ≥ 170 ms) and left axis deviation in the presence of left bundle branch block : A marker of poor left ventricular systolic function? / Das, Mithilesh; Cheriparambil, Kuruvilla; Bedi, Ashwini; Kassotis, John; Reddy, Chatla V R; Makan, Majesh; Dunbar, Christopher C.; Saul, Barry.

In: American Heart Journal, Vol. 142, No. 5, 2001, p. 756-759.

Research output: Contribution to journalArticle

Das, Mithilesh ; Cheriparambil, Kuruvilla ; Bedi, Ashwini ; Kassotis, John ; Reddy, Chatla V R ; Makan, Majesh ; Dunbar, Christopher C. ; Saul, Barry. / Prolonged QRS duration (QRS ≥ 170 ms) and left axis deviation in the presence of left bundle branch block : A marker of poor left ventricular systolic function?. In: American Heart Journal. 2001 ; Vol. 142, No. 5. pp. 756-759.
@article{4bc2895a1e474ec9b2eda90f6ed50859,
title = "Prolonged QRS duration (QRS ≥ 170 ms) and left axis deviation in the presence of left bundle branch block: A marker of poor left ventricular systolic function?",
abstract = "Background: Left bundle branch block (LBBB) is commonly associated with structural heart disease and left ventricular dysfunction. We propose that the QRS duration and degree of left-axis deviation (LAD) identify significant left ventricular systolic dysfunction in patients with LBBB. Methods: In this prospective study the ejection fraction (EF) of 300 consecutive patients with LBBB was evaluated by echocardiography. The relationship between QRS duration and LAD (axis between -30°and -90°) and EF were derived. Results: There was no significant difference in age, sex, presence of ischemic or nonischemic cardiomyopathy and valvular heart disease, and EF among the patients with or without LAD. The EF of patients with QRS ≥170 milliseconds with LAD (n = 20) and without LAD (n = 18) was 25{\%} ± 16{\%} and 23{\%} ± 13{\%}, respectively (P = .71). The mean EF (24{\%} ± 10{\%}) of the patients with a QRS duration of ≥170 milliseconds (n = 38) was significantly lower than the mean EF (36{\%} ± 16{\%}) of the patients with a QRS duration of 2 = 0.13, SE of estimate = 16.21). However, the QRS axis was not significantly correlated with EF and did not have added predictive value. Conclusions: The QRS duration has a significant inverse relationship with EF and prolongation of QRS duration (≥170 milliseconds) in the presence of LBBB is a marker of significant left ventricular systolic dysfunction. The presence of LAD in LBBB does not signify a further decrease in EF.",
author = "Mithilesh Das and Kuruvilla Cheriparambil and Ashwini Bedi and John Kassotis and Reddy, {Chatla V R} and Majesh Makan and Dunbar, {Christopher C.} and Barry Saul",
year = "2001",
doi = "10.1067/mhj.2001.118735",
language = "English (US)",
volume = "142",
pages = "756--759",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Prolonged QRS duration (QRS ≥ 170 ms) and left axis deviation in the presence of left bundle branch block

T2 - A marker of poor left ventricular systolic function?

AU - Das, Mithilesh

AU - Cheriparambil, Kuruvilla

AU - Bedi, Ashwini

AU - Kassotis, John

AU - Reddy, Chatla V R

AU - Makan, Majesh

AU - Dunbar, Christopher C.

AU - Saul, Barry

PY - 2001

Y1 - 2001

N2 - Background: Left bundle branch block (LBBB) is commonly associated with structural heart disease and left ventricular dysfunction. We propose that the QRS duration and degree of left-axis deviation (LAD) identify significant left ventricular systolic dysfunction in patients with LBBB. Methods: In this prospective study the ejection fraction (EF) of 300 consecutive patients with LBBB was evaluated by echocardiography. The relationship between QRS duration and LAD (axis between -30°and -90°) and EF were derived. Results: There was no significant difference in age, sex, presence of ischemic or nonischemic cardiomyopathy and valvular heart disease, and EF among the patients with or without LAD. The EF of patients with QRS ≥170 milliseconds with LAD (n = 20) and without LAD (n = 18) was 25% ± 16% and 23% ± 13%, respectively (P = .71). The mean EF (24% ± 10%) of the patients with a QRS duration of ≥170 milliseconds (n = 38) was significantly lower than the mean EF (36% ± 16%) of the patients with a QRS duration of 2 = 0.13, SE of estimate = 16.21). However, the QRS axis was not significantly correlated with EF and did not have added predictive value. Conclusions: The QRS duration has a significant inverse relationship with EF and prolongation of QRS duration (≥170 milliseconds) in the presence of LBBB is a marker of significant left ventricular systolic dysfunction. The presence of LAD in LBBB does not signify a further decrease in EF.

AB - Background: Left bundle branch block (LBBB) is commonly associated with structural heart disease and left ventricular dysfunction. We propose that the QRS duration and degree of left-axis deviation (LAD) identify significant left ventricular systolic dysfunction in patients with LBBB. Methods: In this prospective study the ejection fraction (EF) of 300 consecutive patients with LBBB was evaluated by echocardiography. The relationship between QRS duration and LAD (axis between -30°and -90°) and EF were derived. Results: There was no significant difference in age, sex, presence of ischemic or nonischemic cardiomyopathy and valvular heart disease, and EF among the patients with or without LAD. The EF of patients with QRS ≥170 milliseconds with LAD (n = 20) and without LAD (n = 18) was 25% ± 16% and 23% ± 13%, respectively (P = .71). The mean EF (24% ± 10%) of the patients with a QRS duration of ≥170 milliseconds (n = 38) was significantly lower than the mean EF (36% ± 16%) of the patients with a QRS duration of 2 = 0.13, SE of estimate = 16.21). However, the QRS axis was not significantly correlated with EF and did not have added predictive value. Conclusions: The QRS duration has a significant inverse relationship with EF and prolongation of QRS duration (≥170 milliseconds) in the presence of LBBB is a marker of significant left ventricular systolic dysfunction. The presence of LAD in LBBB does not signify a further decrease in EF.

UR - http://www.scopus.com/inward/record.url?scp=0034748675&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034748675&partnerID=8YFLogxK

U2 - 10.1067/mhj.2001.118735

DO - 10.1067/mhj.2001.118735

M3 - Article

VL - 142

SP - 756

EP - 759

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 5

ER -