Association of newly developed right bundle branch block with graft rejection following heart transplantation

Jin Ho Kim, Jaewon Oh, Min Ji Kim, In Cheol Kim, Jae Sun Uhm, Hui Nam Pak, Seok Min Kang

Research output: Contribution to journalArticle

Abstract

Purpose: We aimed to examine associations between right bundle branch block (RBBB) following heart transplantation (HT) and graft rejection. Materials and Methods: We investigated 51 patients who underwent endomyocardial biopsies, electrocardiogram, right-side cardiac catheterization, and echocardiography at 1 month and 1 year after HT. We classified patients into four groups according to the development of RBBB, based on electrocardiogram at 1 month and 1 year: 1) sustained RBBB, 2) disappeared RBBB, 3) newly developed RBBB, and 4) sustained non-RBBB. The RBBB was defined as an RSR’ pattern in V1 with a QRS duration ≥100 ms on electrocardiogram. Results: The newly developed RBBB group (n=13, 25.5%) had a higher rate of new onset graft rejection (from grade 0 to grade ≥1R, 30.8% vs. 10.0% vs. 21.4%, p=0.042) at 1 year, compared with sustained RBBB (n=10, 19.6%) and sustained non-RBBB group (n=28, 54.9%). In contrast, the incidence of resolved graft rejection (from grade ≥1R to grade 0) was higher in the sustained RBBB group than the newly developed RBBB and sustained non-RBBB groups (70.0% vs. 7.7% vs. 25.0%, p=0.042). Left atrial volume index was significantly higher in the newly developed RBBB group than the sustained RBBB and sustained non-RBBB groups (60.6±25.9 mL/m2 vs. 36.0±11.0 mL/m2 vs. 38.4±18.1 mL/m2, p=0.003). Conclusion: Close monitoring for new development of RBBB at 1 year after HT, which was associated with a higher incidence of new onset graft rejection, may be helpful to identify high risk patients for graft rejection.

Original languageEnglish
Pages (from-to)423-428
Number of pages6
JournalYonsei medical journal
Volume60
Issue number5
DOIs
Publication statusPublished - 2019 May

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All Science Journal Classification (ASJC) codes

  • Medicine(all)

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