부산대학교 도서관

Purpose: Left bundle branch block (LBBB) is considered an unfavourable prognostic marker in heart disease. Testing for coronary artery disease (CAD) is often prompted by incidental LBBB finding, but published studies disagree about an association between LBBB and CAD. Thus, we assessed the association of LBBB with CAD in patients undergoing coronary CT angiography (CCTA). Methods: We enrolled 818 patients (106 LBBB patients and 712 controls) without known CAD, cardiomyopathy, valvular or congenital heart disease who underwent CCTA. Image quality was assessed on a 4-point scale for each coronary segment. After exclusion of non-diagnostic studies, comparison of CAD prevalence (≥50% coronary stenosis) was performed using triple case-matching for pre-test probability (based on age, gender and typicality of symptoms) in 101 LBBB patients and 303 matched controls. Results: Mean age was 57.2 ± 11.1 years. CAD prevalence did not differ between LBBB patients and matched controls: 15% vs. 16% (p=0.88). Similarly, no significant differences were found in cardiovascular risk factors (CVRF), stenosis severity, CAD extent, non-obstructive disease and vessel-based analysis. In multivariate analysis, age, gender, typical angina and CVRF, but not LBBB (p=0.94), emerged as significant and independent predictors of obstructive CAD. Image quality was very high in LBBB and controls (3.8 versus 3.9). LBBB did not affect image quality in multivariate analysis including technical factors (p=0.70). Conclusion: CAD prevalence is similar in LBBB patients at low-to-moderate pre-test probability compared to controls matched for age, gender, symptom typicality and CVRF. LBBB does not affect image quality in CCTA, which is therefore a useful imaging modality in LBBB patients. Prevalence of CAD by severity