Heart remodeling in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block
Abstract The prevalence of left bundle branch block (LBBB) in the general population is 0.1–0.8 %, and in patients with ST-segment elevation Q-wave myocardial infarction (Q-MI) varies from 1 % to 15 %. The aim - to evaluate the structural and functional features of the heart in patients with a...
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Zaporizhzhia State Medical and Pharmaceutical University
2018-06-01
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| Series: | Zaporožskij Medicinskij Žurnal |
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| Online Access: | http://zmj.zsmu.edu.ua/article/view/130847/130581 |
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| author | V. D. Syvolap Ya. V. Zemlyaniy |
| author_facet | V. D. Syvolap Ya. V. Zemlyaniy |
| author_sort | V. D. Syvolap |
| collection | DOAJ |
| description | Abstract
The prevalence of left bundle branch block (LBBB) in the general population is 0.1–0.8 %, and in patients with ST-segment elevation Q-wave myocardial infarction (Q-MI) varies from 1 % to 15 %.
The aim - to evaluate the structural and functional features of the heart in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block.
Materials and methods. The study involved 60 patients with Q-MI (40 men and 20 women), who were hospitalized in cardiology department for patients with myocardial infarction treatment of Zaporizhzhіa City Emergency and Urgent Care Clinic. Patients were divided into two groups: 40 patients with Q-MI and the LBBB (the mean age was 71.53 ± 1.23 years), 20 patients with Q-MI without LBBB (the mean age was 65.47 ± 2.25 years). Assessment of intracardiac hemodynamics were performed by echocardiography using a “MyLab50” (“Esaote”,Italy) ultrasound system on the recommendations of the American Society of Echocardiography.
Results. Patients with acute Q-MI with LBBB were significantly older than patients who had acute Q-MI without LBBB (9.2 %, P < 0.05). Patients with anterior acute Q-MI prevailed among persons with LBBB (75 %). Thickening of the posterior wall (by 9.6 %; P < 0.05), an increase in LVMMI (by 11.2 %; P < 0.05), an increase in end-diastolic size (by 12.9 %; P < 0.05) and end-systolic size (by 18.6 %; P < 0.05); acceleration of MVE (by 18.3 %; P < 0.05); and an increase systolic pressure in the pulmonary artery (by 23.1 %; P < 0.05) were found in patients with Q-MI with LBBB compared to patients with Q-MI without LBBB. The analysis of contingency table revealed significant association between LBBB presence in patients with Q-MI and diabetes mellitus (χ2 = 4.53; P < 0.05), female gender (χ2 = 3.87; P < 0.05) and age over 65 years (χ2 = 5.71; P < 0.05). In patients with acute Q-MI and LBBB a significant positive correlation between the QRS width and end-diastolic size (+0.49; P < 0.05), end-systolic size (+0.45; P < 0.05), systolic pressure in pulmonary artery (+0.31; P < 0.05) and diastolic size of right ventricle (+0.38; P < 0.05), and a negative correlation between the QRS width and ejection fraction (-0.71; P < 0.05) and IVRT (-0.37; P < 0.05) were noted.
Conclusions. LBBB in patients with acute Q-MI is associated with female gender, age over 65 years and past history of diabetes mellitus. Acute Q-MI in the presence of LBBB is characterized by eccentric hypertrophy with an increase in the left ventricular size and pulmonary hypertension. QRS complex duration in patients with acute Q-MI and LBBB is associated with systolic function deterioration, left ventricular dilatation and pulmonary hypertension. |
| format | Article |
| id | doaj-art-61dca0cd18d44fde9739dcf5d04cb892 |
| institution | DOAJ |
| issn | 2306-4145 2310-1210 |
| language | English |
| publishDate | 2018-06-01 |
| publisher | Zaporizhzhia State Medical and Pharmaceutical University |
| record_format | Article |
| series | Zaporožskij Medicinskij Žurnal |
| spelling | doaj-art-61dca0cd18d44fde9739dcf5d04cb8922025-08-20T03:19:28ZengZaporizhzhia State Medical and Pharmaceutical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102018-06-01331932310.14739/2310-1210.2018.3.130847Heart remodeling in patients with acute Q-wave myocardial infarction in the presence of left bundle branch blockV. D. SyvolapYa. V. ZemlyaniyAbstract The prevalence of left bundle branch block (LBBB) in the general population is 0.1–0.8 %, and in patients with ST-segment elevation Q-wave myocardial infarction (Q-MI) varies from 1 % to 15 %. The aim - to evaluate the structural and functional features of the heart in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block. Materials and methods. The study involved 60 patients with Q-MI (40 men and 20 women), who were hospitalized in cardiology department for patients with myocardial infarction treatment of Zaporizhzhіa City Emergency and Urgent Care Clinic. Patients were divided into two groups: 40 patients with Q-MI and the LBBB (the mean age was 71.53 ± 1.23 years), 20 patients with Q-MI without LBBB (the mean age was 65.47 ± 2.25 years). Assessment of intracardiac hemodynamics were performed by echocardiography using a “MyLab50” (“Esaote”,Italy) ultrasound system on the recommendations of the American Society of Echocardiography. Results. Patients with acute Q-MI with LBBB were significantly older than patients who had acute Q-MI without LBBB (9.2 %, P < 0.05). Patients with anterior acute Q-MI prevailed among persons with LBBB (75 %). Thickening of the posterior wall (by 9.6 %; P < 0.05), an increase in LVMMI (by 11.2 %; P < 0.05), an increase in end-diastolic size (by 12.9 %; P < 0.05) and end-systolic size (by 18.6 %; P < 0.05); acceleration of MVE (by 18.3 %; P < 0.05); and an increase systolic pressure in the pulmonary artery (by 23.1 %; P < 0.05) were found in patients with Q-MI with LBBB compared to patients with Q-MI without LBBB. The analysis of contingency table revealed significant association between LBBB presence in patients with Q-MI and diabetes mellitus (χ2 = 4.53; P < 0.05), female gender (χ2 = 3.87; P < 0.05) and age over 65 years (χ2 = 5.71; P < 0.05). In patients with acute Q-MI and LBBB a significant positive correlation between the QRS width and end-diastolic size (+0.49; P < 0.05), end-systolic size (+0.45; P < 0.05), systolic pressure in pulmonary artery (+0.31; P < 0.05) and diastolic size of right ventricle (+0.38; P < 0.05), and a negative correlation between the QRS width and ejection fraction (-0.71; P < 0.05) and IVRT (-0.37; P < 0.05) were noted. Conclusions. LBBB in patients with acute Q-MI is associated with female gender, age over 65 years and past history of diabetes mellitus. Acute Q-MI in the presence of LBBB is characterized by eccentric hypertrophy with an increase in the left ventricular size and pulmonary hypertension. QRS complex duration in patients with acute Q-MI and LBBB is associated with systolic function deterioration, left ventricular dilatation and pulmonary hypertension.http://zmj.zsmu.edu.ua/article/view/130847/130581ventricular remodeling bundle-branch blockmyocardial infarction |
| spellingShingle | V. D. Syvolap Ya. V. Zemlyaniy Heart remodeling in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block Zaporožskij Medicinskij Žurnal ventricular remodeling bundle-branch block myocardial infarction |
| title | Heart remodeling in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block |
| title_full | Heart remodeling in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block |
| title_fullStr | Heart remodeling in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block |
| title_full_unstemmed | Heart remodeling in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block |
| title_short | Heart remodeling in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block |
| title_sort | heart remodeling in patients with acute q wave myocardial infarction in the presence of left bundle branch block |
| topic | ventricular remodeling bundle-branch block myocardial infarction |
| url | http://zmj.zsmu.edu.ua/article/view/130847/130581 |
| work_keys_str_mv | AT vdsyvolap heartremodelinginpatientswithacuteqwavemyocardialinfarctioninthepresenceofleftbundlebranchblock AT yavzemlyaniy heartremodelinginpatientswithacuteqwavemyocardialinfarctioninthepresenceofleftbundlebranchblock |