Hannink Laura G J, Wagner Galen S, Kisslo Joseph, Alenezi Fawaz Abdulaziz M, Shaw Linda K, Hofmann Paul, Zusterzeel Robbert, Phelan Matthew, Velazquez Eric J, Gorgels Anton P M
Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands; Duke Clinical Research Institute, Durham, NC, USA.
Department of Medicine, Division of Cardiology, Duke University Medical Center, Durham, NC, USA.
J Electrocardiol. 2015 Jul-Aug;48(4):637-42. doi: 10.1016/j.jelectrocard.2015.04.010. Epub 2015 May 1.
New-onset left bundle branch block (LBBB) is a known complication during Transcatheter Aortic Valve Replacement (TAVR). This study evaluated the influence of pre-TAVR cardiac conditions on left ventricular functions in patients with new persistent LBBB post-TAVR.
Only 11 patients qualified for this study because of the strict inclusion criteria. Pre-TAVR electrocardiograms were evaluated for Selvester QRS infarct score and QRS duration, and left ventricular end-systolic volume (LVESV) was used as outcome variable.
There was a trend towards a positive correlation between QRS score and LVESV of r=0.59 (p=0.058), while there was no relationship between QRS duration and LVESV (r=-0.18 [p=0.59]).
This study showed that patients with new LBBB and higher pre-TAVR QRS infarct score may have worse post-TAVR left ventricular function, however, pre-TAVR QRS duration has no such predictive value. Because of the small sample size these results should be interpreted with caution and assessed in a larger study population.
新发左束支传导阻滞(LBBB)是经导管主动脉瓣置换术(TAVR)期间已知的一种并发症。本研究评估了TAVR术前心脏状况对TAVR术后新发持续性LBBB患者左心室功能的影响。
由于纳入标准严格,仅有11例患者符合本研究要求。对TAVR术前心电图进行Selvester QRS梗死评分和QRS时限评估,并将左心室收缩末期容积(LVESV)用作结果变量。
QRS评分与LVESV之间呈正相关趋势,r = 0.59(p = 0.058),而QRS时限与LVESV之间无相关性(r = -0.18 [p = 0.59])。
本研究表明,新发LBBB且TAVR术前QRS梗死评分较高的患者TAVR术后左心室功能可能较差,然而,TAVR术前QRS时限并无此类预测价值。由于样本量较小,这些结果应谨慎解读,并在更大的研究人群中进行评估。