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Association of left bundle branch block with obstructive coronary artery disease on coronary CT angiography: a

Olivier F Clerc1, Mathias Possner2, René Maire3

  • 1Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland Department of Cardiology, University Hospital Zurich, Ramistrasse 100, Zurich CH-8091, Switzerland.

European Heart Journal. Cardiovascular Imaging
|August 31, 2015
PubMed

Insights

Left bundle branch block (LBBB) does not predict coronary artery disease (CAD) in patients without known heart disease. Coronary computed tomography angiography (CCTA) shows similar CAD prevalence and image quality in LBBB patients and controls.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Medical Research

Background:

  • Left bundle branch block (LBBB) is an unfavorable prognostic marker in heart disease.
  • The association between LBBB and coronary artery disease (CAD) is debated.
  • Coronary computed tomography angiography (CCTA) is increasingly used for CAD evaluation.

Purpose of the Study:

  • To assess the association between LBBB and previously unknown CAD.
  • To evaluate the utility of CCTA in patients with incidental LBBB findings.
  • To compare CAD prevalence and severity in LBBB patients versus controls.

Main Methods:

  • 818 patients without known CAD underwent CCTA.
  • 106 patients with new LBBB were compared to 712 controls.
  • Triple case-matching for pre-test probability was used.
  • Obstructive CAD was defined as ≥50% stenosis.

Main Results:

  • No significant difference in obstructive CAD prevalence between LBBB patients (15%) and matched controls (16%).
  • Comparable cardiovascular risk factors, stenosis severity, and CAD extent between groups.
  • High and comparable image quality of CCTA in both LBBB and control groups.
  • LBBB was not an independent predictor of obstructive CAD on multivariate analysis.

Conclusions:

  • CAD prevalence is similar in LBBB patients with low-to-moderate pre-test probability compared to controls.
  • CCTA is a valuable tool in LBBB patients, yielding high image quality.
  • LBBB itself is not a predictor of CAD in this patient cohort.
Abstract

Keywords:
Coronary CT angiographyCoronary artery diseaseLeft bundle branch block

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