Predictors of ventricular dysfunction and coronary artery disease in patients with Left Bundle Branch Block

Background:: Patients with coronary artery disease and concomitant left bundle branch block have increasing cardiovascular mortality rates in comparison with those with coronary artery disease but without left bundle branch block. In patients with left bundle branch block, therefore, the delineation of the severity of coronary artery disease may be helpful in providing prognostic information. This study was performed to assess clinical and demographic predictors of coronary artery disease and left ventricular (LV) dysfunction in patients with left bundle branch block. Methods: In this cross-sectional study 219 patients with left bundle branch block and suspected coronary artery disease that underwent coronary angiography, were assessed for coronary artery disease and left ventricular dysfunction. Clinical and demographic variables that might help identify these patients were recorded. Results: Coronary artery disease was present in 124 (56.3 %) of patients and left ventricular ejection fraction < 50% was seen in 147 (67.1%) of cases. Advanced age (p=0.001), male gender (p=0.027, OR=1.94), history of chest pain (0.015) and left ventricular ejection fraction < 50% (0.026, OR=3.04) were predictors of CAD. In addition, older age (p=0.004), male gender (p=0.017), history of diabetes (0.043, OR=1.45) and angiographically documented CAD (p=0.001, OR=3.41) were predictors of left ventricular dysfunction. Conclusion: Certain clinical and demographic characteristics may help differentiate left bundle branch block patients with concomitant coronary artery disease and left ventricular dysfunction from other cardiac disorders.