| Abstract | Prognostički značaj bloka desne grane (BDG) u hospitaliziranih pacijenata zbog zatajivanja srca (ZS) je i dalje nejasan te smo ga istražili
Ispitivanje je obuhvatilo 1820 pacijenata s ZS hospitaliziranih na Zavodu za kardiovaskularne bolesti, KBC Rijeka u periodu 2006. – 2012. godine. Ispitivane varijable su uspoređene s grupama pacijenata bez bloka, s BLG i BDG. U grupi pacijenata s BDG uspoređivani su pacijenti koji su otpušteni živi nasuprot onih koji su preminuli. Od ukupnog broja pacijenata (prosječnih 75.1±10.1 godine, 48.8% muškaraca, prosječna NYHA klasa od 3.6; NT-proBNP 1323.4±1673.7 pmol/L; ultrazvuk srca je učinjen kod 73.4% pacijenata), njih 1380 je bez bloka (75.8%), s BLG 275 (15.1%) i s BDG 165 (9,1%). Pacijenti s BDG su stariji, više žena i sporijom srčanom frekvencijom. Prosječna NYHA klasa kod pacijenata bez bloka je 3,6, a s BLG i BDG 3.7, te su kod njih uočene veće vrijednosti NT-proBNP. Najniža istisna frakcija je bila kod pacijenata s BLG. Ureja i kreatinin su veći kod pacijenata s BLG i BDG. Smrtnost kod pacijenata bez bloka je 14.3%, kod BLG 19,6% i 20.6% kod BLG. Preminuli pacijenti s BDG su stariji, s nižim krvnim tlakom, eGFR i EF, većim vrijednostima srčane frekvencije, troponina, NYHA klasom, NT-proBNP, urejom i kreatininom. Bolnička smrtnost u pacijenata s ZS i BDG jednako je visoka kao i kod BLG, što je značajno veće nego kod pacijenata bez bloka. Starija dob, niži krvni tlak, EF i lošija bubrežna funkcija te veća frekvencija srca, NYHA klasa, vrijednosti troponina i NT-proBNP sugeriraju lošiji ishod. |
| Abstract (english) | The prognostic significance of right bundle branch block (RBBB) in hospitalized heart failure (HF) patients is unclear. I want to determine its prognostic value during hospital stay.
The population consisted of the patients treated in Department of Cardiovascular Diseases, Clinical Hospital Center Rijeka, from 2006 to 2012. Variables were compared between group without BBB, with LBBB and RBBB and in group with RBBB between patients who were alive discharged and those deceased.
There were totally 1820 patients (age 75.1±10.1 years; men 48.8%; mean NYHA class 3.6; NT-proBNP 1323.4±1673.7 pmol/L; echocardiography in 73.4%). Group without BBB consisted of 1380 (75.8%), LBBB 275 (15.1%) and RBBB 165 (9,1%) patients. RBBB patients were older and slower heart rate. Mean NYHA class was 3.7 in RBBB and LBBB patients and 3.6 in group without BBB, with NT-proBNP value higher in RBBB and LBBB patients. The lowest left ventricular EF was found in LBBB patients. Serum urea and creatinine were higher in RBBB and LBBB patients. Mortality was 14.3% in group without BBB, 19,6% in LBBB and 20.6% in RBBB group. Deceased patients in RBBB group were older, with lower blood pressure, eGFR and EF and with higher HR, troponin, NYHA class, NT-proBNP, urea and creatinine values than survivors.
The hospital mortality in HF patients with RBBB is as high as in those with LBBB and significantly higher than in patients without BBB. Older age, lower blood pressure and EF, poorer renal function and higher HR, NYHA class, troponin and NT-proBNP suggest adverse hospital outcome. |
