[Structural-functional peculiarities of the heart and survival of elderly patients with chronic heart failure and left bundle branch block].

AIM: To study structural-functional characteristics of the heart and survival of elderly patients with chronic heart failure (CHF) and left bundle branch block (LBBB).

MATERIAL AND

METHODS

We examined and followed-up 108 patients aged 60-85 years with NYHA class II-IV CHF with and without LBBB.

RESULTS

Patients of both groups were comparable according to sex, age, CHF duration and severity, hemodynamic parameters, clinical condition, quality of life, and spectrum of taken drugs. Patients with LBBB had statistically significant increases of end diastolic (p<0.001) and systolic (p<0.001) dimensions, end diastolic (p<0.001) and systolic (p<0.001) volumes, sphericity index (p<0.001), long axis (p<0.05), decreases of relative thickness of the left ventricle (p<0.05), interventricular septum (p<0.001), and left ventricular ejection fraction (p<0.001). Pronounced mitral regurgitation also was more frequent in patients with LBBB (p<0.01). During follow up 14/34 patients (41.2%) with LBBB and 19/74 patients (25.7%) without LBBB died. There were 10 and 9 sudden deaths among patients with and without LBBB, respectively.

CONCLUSION

In patients with LBBB development of CHF is associated with changes of left ventricular geometry. Sudden death is the most frequent cause of death of these patients.