Left bundle branch block as an electrocardiographic pattern at presentation of patients with Tako-tsubo cardiomyopathy

Guido Parodi, Claudia Salvadori, Stefano Del Pace, Benedetta Bellandi, Nazario Carrabba, Gian Franco Gensini, David Antoniucci

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Tako-tsubo cardiomyopathy (TTC) is a recently described clinical condition that may mimic acute myocardial infarction. The presence or new onset of left bundle branch block (LBBB) is associated with adverse outcome in patients with acute myocardial infarction. Objective: We sought to assess the incidence, clinical profile, and outcome of patients with TTC and LBBB at presentation. Methods and results: From July 2003 to December 2006, 84 consecutive patients met the diagnostic criteria for TTC. LBBB was present in eight (9%) patients at presentation. Patients with LBBB tended to be older (77 ± 11 years versus 72 ± 10 years; P = 0.186), and with a more frequent, but not statistically significant, history of hypertension (75 versus 53%; P = 0.227), and chronic renal failure (25 versus 8%, P = 0.117). Moreover, patients with LBBB showed a higher peak creatine kinase-MB value (76 ± 32U/l versus 21 ± 31 U/l; P = 0.005), and a lower, but not significantly, baseline left ventricular ejection fraction (30 ± 13% versus 36 ± 9%; P = 0.107), as compared with patients without LBBB. Follow-up length was 12 ± 10 months. The mortality rate was higher in patients with LBBB as compared with those without (25 and 3%; P = 0.005). However, at Cox analysis the only independent predictor of death was age (P = 0.042). Conclusion: LBBB was documented at presentation in 9% of TTC patients. At long-term follow-up, TTC patients with LBBB showed increased unadjusted mortality. However, when adjusted for age, baseline characteristics, and concomitant diseases, LBBB did not appear to be an independent predictor of poor outcome in patients with TTC.

Original languageEnglish
Pages (from-to)100-103
Number of pages4
JournalJournal of Cardiovascular Medicine
Volume10
Issue number1
DOIs
Publication statusPublished - Jan 2009

Keywords

  • Acute myocardial infarction
  • Left bundle branch block
  • Outcome
  • Tako-tsubo cardiomyopathy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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