Evidence map›Paper›PMID 38607371›Full record

ArticleESC heart failure2024

Outcomes with T-wave discordance of left bundle branch block and preserved or mildly reduced ejection fraction.

Hui-Chun Huang, Kuo-Liong Chien, Yen-Bin Liu

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Hui-Chun HuangDepartment of Internal Medicine, Division of Cardiology, National Taiwan University Hospital and National Taiwan University College of Medicine, National Taiwan University, No. 7 Chung-Shan South Rd, Taipei, 100, Taiwan.
Kuo-Liong ChienDepartment of Internal Medicine, Division of Cardiology, National Taiwan University Hospital and National Taiwan University College of Medicine, National Taiwan University, No. 7 Chung-Shan South Rd, Taipei, 100, Taiwan.
Yen-Bin LiuDepartment of Internal Medicine, Division of Cardiology, National Taiwan University Hospital and National Taiwan University College of Medicine, National Taiwan University, No. 7 Chung-Shan South Rd, Taipei, 100, Taiwan.
National Taiwan University Hospital · TWNational Taiwan University · TW

Funding

National Taiwan University Hospital 111-X0032
6 · The paper itself

Abstract

aimsLeft bundle branch block (LBBB) is associated with an increased risk of adverse outcomes for patients with heart failure. The prognosis of LBBB in patients with a preserved ejection fraction (EF) remains controversial. This study investigated the predictive value of T-wave discordance for the prognosis of patients with LBBB and preserved or mildly reduced EF. METHODS AND

resultsWe enrolled 707 patients with complete LBBB and left ventricular (LV) EF ≥ 40% observed using electrocardiograms (ECGs) and echocardiograms between January 2010 and December 2018. Their serial ECGs were reviewed during the follow-up period. The T-wave pattern was classified as discordant LBBB (dLBBB) or concordant LBBB (cLBBB) according to the 12-lead ECG T-wave morphology. The primary outcome was the composite of cardiovascular death or hospitalization for heart failure during a median follow-up period of 3.1 years. A multivariable Cox regression analysis was used to evaluate the independent predictors of the primary outcome. Patients with dLBBB had more comorbidities, a higher heart rate, a longer QRS and QTc duration, a larger LV end-systolic volume and left atrial dimension, a lower LVEF, and a higher mitral E/A ratio and E/e', compared with those with cLBBB. Older age [hazard ratio (HR) = 1.023, 95% confidence interval (CI) = 1.001-1.046, P = 0.023], history of heart failure (HR = 2.440, 95% CI = 1.524-3.905, P = 0.001), chronic kidney disease (HR = 1.917, 95% CI = 1.182-3.110, P = 0.008), larger LV end-systolic volume (HR = 1.046, 95% CI = 1.017-1.075, P = 0.002), lower LVEF (HR = 0.916, 95% CI = 0.885-0.948, P = 0.001), and presence of dLBBB (HR = 1.63, 95% CI = 1.011-2.628, P = 0.032) were independent predictors of the primary outcome in patients with LBBB and LVEF ≥ 40%. The discordant or concordant T-wave morphology of LBBB could transform from one subtype to the other in up to 23% of the study population during the follow-up period, and individuals with persistent or transformed dLBBB faced an increased risk of cardiovascular death or non-fatal heart failure hospitalization.

conclusionsIn patients with LBBB and EF ≥ 40%, dLBBB serves as an independent predictor of a higher risk of cardiovascular death or non-fatal heart failure hospitalization.

Indexed as

Bundle-Branch BlockElectrocardiographyStroke VolumeVentricular Function, LeftAgedEchocardiographyFemaleFollow-Up StudiesHeart FailureHumansMaleMiddle AgedPrognosisRetrospective StudiesLeft bundle branch blockOutcomePreserved ejection fractionT‐wave discordance

Identifiers

PMID38607371
PMCPMC11287352
OpenAlexW4394763030

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.