Prognostic significance of left axis deviation in acute heart failure patients with left bundle branch block: An analysis from the Korean Acute Heart Failure (KORAHF) registry

Ki Hong Choi, Seongwook Han, Ga Yeon Lee, Jin Oh Choi, Eun Seok Jeon, Hae Young Lee, Sang Eun Lee, Jae Joong Kim, Shung Chull Chae, Sang Hong Baek, Seok Min Kang, Dong Ju Choi, Byung Su Yoo, Kye Hun Kim, Myeong Chan Cho, Hyun Young Park, Byung Hee Oh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and Objectives: The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods: Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <−30 degree. The primary outcome was all-cause mortality. Results: The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, −3.25; 95% confidence interval, −5.82, −0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).

Original languageEnglish
Pages (from-to)1002-1011
Number of pages10
JournalKorean Circulation Journal
Volume48
Issue number11
DOIs
Publication statusPublished - 2018 Nov

Fingerprint

Bundle-Branch Block
Registries
Heart Failure
Stroke Volume
Heart Ventricles
Dilatation
Confidence Intervals
Mortality
Tertiary Care Centers
Cause of Death
Linear Models
Multivariate Analysis
Extremities
Regression Analysis
Lead

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Choi, Ki Hong ; Han, Seongwook ; Lee, Ga Yeon ; Choi, Jin Oh ; Jeon, Eun Seok ; Lee, Hae Young ; Lee, Sang Eun ; Kim, Jae Joong ; Chae, Shung Chull ; Baek, Sang Hong ; Kang, Seok Min ; Choi, Dong Ju ; Yoo, Byung Su ; Kim, Kye Hun ; Cho, Myeong Chan ; Park, Hyun Young ; Oh, Byung Hee. / Prognostic significance of left axis deviation in acute heart failure patients with left bundle branch block : An analysis from the Korean Acute Heart Failure (KORAHF) registry. In: Korean Circulation Journal. 2018 ; Vol. 48, No. 11. pp. 1002-1011.
@article{c2d88529cbb44801b18984b6f3cc4549,
title = "Prognostic significance of left axis deviation in acute heart failure patients with left bundle branch block: An analysis from the Korean Acute Heart Failure (KORAHF) registry",
abstract = "Background and Objectives: The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods: Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <−30 degree. The primary outcome was all-cause mortality. Results: The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7{\%} vs. 46.6{\%}, adjusted hazard ratio, 1.01; 95{\%} confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, −3.25; 95{\%} confidence interval, −5.82, −0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).",
author = "Choi, {Ki Hong} and Seongwook Han and Lee, {Ga Yeon} and Choi, {Jin Oh} and Jeon, {Eun Seok} and Lee, {Hae Young} and Lee, {Sang Eun} and Kim, {Jae Joong} and Chae, {Shung Chull} and Baek, {Sang Hong} and Kang, {Seok Min} and Choi, {Dong Ju} and Yoo, {Byung Su} and Kim, {Kye Hun} and Cho, {Myeong Chan} and Park, {Hyun Young} and Oh, {Byung Hee}",
year = "2018",
month = "11",
doi = "10.4070/kcj.2018.0048",
language = "English",
volume = "48",
pages = "1002--1011",
journal = "Korean Circulation Journal",
issn = "1738-5520",
publisher = "Korean Society of Circulation",
number = "11",

}

Choi, KH, Han, S, Lee, GY, Choi, JO, Jeon, ES, Lee, HY, Lee, SE, Kim, JJ, Chae, SC, Baek, SH, Kang, SM, Choi, DJ, Yoo, BS, Kim, KH, Cho, MC, Park, HY & Oh, BH 2018, 'Prognostic significance of left axis deviation in acute heart failure patients with left bundle branch block: An analysis from the Korean Acute Heart Failure (KORAHF) registry', Korean Circulation Journal, vol. 48, no. 11, pp. 1002-1011. https://doi.org/10.4070/kcj.2018.0048

Prognostic significance of left axis deviation in acute heart failure patients with left bundle branch block : An analysis from the Korean Acute Heart Failure (KORAHF) registry. / Choi, Ki Hong; Han, Seongwook; Lee, Ga Yeon; Choi, Jin Oh; Jeon, Eun Seok; Lee, Hae Young; Lee, Sang Eun; Kim, Jae Joong; Chae, Shung Chull; Baek, Sang Hong; Kang, Seok Min; Choi, Dong Ju; Yoo, Byung Su; Kim, Kye Hun; Cho, Myeong Chan; Park, Hyun Young; Oh, Byung Hee.

In: Korean Circulation Journal, Vol. 48, No. 11, 11.2018, p. 1002-1011.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic significance of left axis deviation in acute heart failure patients with left bundle branch block

T2 - An analysis from the Korean Acute Heart Failure (KORAHF) registry

AU - Choi, Ki Hong

AU - Han, Seongwook

AU - Lee, Ga Yeon

AU - Choi, Jin Oh

AU - Jeon, Eun Seok

AU - Lee, Hae Young

AU - Lee, Sang Eun

AU - Kim, Jae Joong

AU - Chae, Shung Chull

AU - Baek, Sang Hong

AU - Kang, Seok Min

AU - Choi, Dong Ju

AU - Yoo, Byung Su

AU - Kim, Kye Hun

AU - Cho, Myeong Chan

AU - Park, Hyun Young

AU - Oh, Byung Hee

PY - 2018/11

Y1 - 2018/11

N2 - Background and Objectives: The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods: Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <−30 degree. The primary outcome was all-cause mortality. Results: The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, −3.25; 95% confidence interval, −5.82, −0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).

AB - Background and Objectives: The prognostic impact of left axis deviation (LAD) on clinical outcomes in acute heart failure syndrome (AHFS) with left bundle branch block (LBBB) is unknown. The aim of this study was to determine the prognostic significance of axis deviation in acute heart failure patients with LBBB. Methods: Between March 2011 and February 2014, 292 consecutive AHFS patients with LBBB were recruited from 10 tertiary university hospitals. They were divided into groups with no LAD (n=189) or with LAD (n=103) groups according to QRS axis <−30 degree. The primary outcome was all-cause mortality. Results: The median follow-up duration was 24 months. On multivariate analysis, the rate of all-cause death did not significantly differ between the normal axis and LAD groups (39.7% vs. 46.6%, adjusted hazard ratio, 1.01; 95% confidence interval, 0.66, 1.53; p=0.97). However, on the multiple linear regression analysis to evaluate the predictors of the left ventricular ejection fraction (LVEF), presence of LAD significantly predicted a worse LVEF (adjusted beta, −3.25; 95% confidence interval, −5.82, −0.67; p=0.01). Right ventricle (RV) dilatation was defined as at least 2 of 3 electrocardiographic criteria (late R in lead aVR, low voltages in limb leads, and R/S ratio <1 in lead V5) and was more frequent in the LAD group than in the normal axis group (p<0.001). Conclusions: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).

UR - http://www.scopus.com/inward/record.url?scp=85056423989&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056423989&partnerID=8YFLogxK

U2 - 10.4070/kcj.2018.0048

DO - 10.4070/kcj.2018.0048

M3 - Article

AN - SCOPUS:85056423989

VL - 48

SP - 1002

EP - 1011

JO - Korean Circulation Journal

JF - Korean Circulation Journal

SN - 1738-5520

IS - 11

ER -