Correlation between ventricular septal mid-wall fibrosis and left bundle branch block and its predictive value to new-onset left bundle branch block
Liu Xiaojie
Li Muzhang
Chen Jiaying
Chen Shufang
Wu Jintao
Zhang Leiming
Li Xuejie
Meng Lingjuan
Abstract：Objective To investigate the correlation between ventricular septal mid-wall fibrosis(SMF)and left bundle branch block(LBBB),and review the predictive value of SMF to new-onset LBBB through analyzing risk factors of LBBB.Methods The clinical materials were retrospectively analyzed in patients undergone examination of cardiac magnetic resonance(CMR)in Heart Center of Henan Provincial People's Hospital from Jan.2018 to Jan.2022.All patients were divided,according to whether there was LBBB in electrocardiogram(ECG)or not,into LBBB group and non-LBBB group.The clinical materials were compared between 2 groups.The correlative risk factors of LBBB were analyzed by using single-factor and multi-factor Logistic regression analysis.The patients in non-LBBB group were followed up by telephone until new-onset LBBB occurrence or until Oct.2023,and risk factors of new-onset LBBB were analyzed by using single-factor and multi-factor Cox regression analysis.Results Compared with non-LBBB group,in LBBB group,patients were older,the indexes of left atrial diameter(LAD),left ventricular mass(LVM),left ventricular internal dimension-diastole(LVIDd),left ventricular end-systolic diameter(LVESd),left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)were higher,left ventricular ejection fraction(LVEF)was lower,QT interval was longer,and incidence rates of dilated cardiomyopathy(DCM)and SMF were higher(P＜0.05).The results of multi-factor Logistic regression analysis showed that age(OR=1.073,95％CI:1.049～1.097:P＜0.001),LVM(OR=1.010,95％CI:1.004～1.016:P=0.001)and SMF(OR=2.227,95％CI:1.232～4.028:P=0.008)were independent correlative factors of LBBB.The patients were followed up meanly for(43.4±11.7)months,and there were 42 patients with new-onset LBBB.The results of Kaplan-Meier analysis showed that proportion of new-onset LBBB was higher in patients with SMF than that in those without SMF(18.5％vs.6.9％,P＜0.001).The results of multi-factor Cox regression analysis showed that age(HR=1.042,95％CI:1.018～1.066,P＜0.001),LVM(HR=1.012,95％CI:1.005～1.020,P=0.001)and SMF(HR=3.320,95％CI:1.768～6.232,P＜0.001)were independent predictive factors for new-onset LBBB.Conclusion SMF is correlated to LBBB and is an independent predictive factor for LBBB.There is a higher risk of LBBB in patients with SMF presented by CMR,so these patients should be paid more attention to.
Keywords：Left bundle branch blockVentricular septal mid-wall fibrosisCardiac magnetic resonanceCorrelation
Publication Date：2024-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1335-1340 )