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Nonspecific intraventricular conduction delay predicts the prognosis of dilated cardiomyopathy

Yong Yuan1,2, Kai Yang1, Qianjun Liu3

  • 1Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.

BMC Cardiovascular Disorders
|August 18, 2023
PubMed

Insights

Nonspecific intraventricular conduction delay (NSIVCD) is an unfavorable prognostic marker in dilated cardiomyopathy (DCM) patients. This finding is independent of other key clinical factors, highlighting the importance of NSIVCD in DCM prognosis.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Imaging

Background:

  • Left bundle branch block (LBBB) is a known adverse prognostic indicator in dilated cardiomyopathy (DCM).
  • Prognostic data for nonspecific intraventricular conduction delay (NSIVCD) in DCM are limited and conflicting.

Purpose of the Study:

  • To evaluate the prognostic significance of NSIVCD in patients with DCM.
  • To compare the outcomes of DCM patients with NSIVCD to those with LBBB, RBBB, and no intraventricular conduction delay (IVCD).

Main Methods:

  • 548 DCM patients undergoing cardiovascular magnetic resonance imaging (CMR) were categorized into four groups: LBBB, RBBB, NSIVCD, and no IVCD.
  • Patients were followed for a median of 58 months for composite endpoints including cardiovascular death, heart transplantation, and malignant arrhythmias.
  • Kaplan-Meier analysis and Cox proportional hazards regression were used to analyze associations between IVCD patterns and outcomes.

Main Results:

  • Patients with NSIVCD and LBBB exhibited higher event rates compared to those without IVCD; RBBB did not show a significant difference.
  • Multivariate Cox regression identified LBBB, NSIVCD, NYHA class, LVEF, LVEDDI, LGE%, and GLS as independent predictors of adverse outcomes in DCM.
  • The average age of the cohort was 46 ± 15 years, with 72.6% males.

Conclusions:

  • Nonspecific intraventricular conduction delay (NSIVCD) is an independent unfavorable prognostic marker in DCM patients.
  • This prognostic value of NSIVCD holds true irrespective of other clinical parameters like LVEDDI, NYHA class, LVEF, LGE%, and GLS.
  • The findings underscore the clinical importance of identifying and assessing NSIVCD in the management of DCM.
Abstract

Keywords:
Bundle branch blockDilated cardiomyopathyMagnetic resonance imagingPrognosis

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