title: Myocardial degradation and left bundle branch block predict conversion to low ejection fraction in heart failure with preserved systolic function.
abstract: The authors prospectively investigated whether left bundle branch block (LBBB) and myocardial degradation as indicated by elevated troponin T (tnT) predict the phenomenon of systolic conversion to low ejection fraction (EF <or=40%) in patients with nonsignificant coronary disease and heart failure with preserved systolic function (HFPSF) (initial EF >40%). Thirty consecutive patients with HFPSF were included and followed over a 4-year interval. A follow-up EF assessment was performed in 25 patients. Six of 15 patients with tnT >or=0.01 ng/mL demonstrated systolic conversion to low EF on follow-up, while none of the 10 patients with tnT <0.01 ng/mL experienced this phenomenon (P=.03). Five of the 6 converters presented with LBBB, while only 1 of the 19 nonconverters had this abnormality (P=.0007). Four of the 6 converters had an initial EF >50%. Myocardial degradation and LBBB predicted systolic conversion in HFPSF patients with nonsignificant coronary disease.
authors.affiliation: Kaufman Center for Heart Failure, Department of Cardiovascular Diseases, Cleveland Clinic Foundation, Cleveland, OH, USA. angheloiu@pol.net
authors.forename: George O
authors.initials: GO
authors.lastname: Angheloiu
authors.forename: Mouyyad
authors.initials: M
authors.lastname: Rahaby
authors.forename: Randall C
authors.initials: RC
authors.lastname: Starling
authors.forename: Viorel
authors.initials: V
authors.lastname: Angheloiu
authors.forename: Dennis M
authors.initials: DM
authors.lastname: McNamara
authors.forename: Mohamad H
authors.initials: MH
authors.lastname: Yamani
authors.forename: James B
authors.initials: JB
authors.lastname: Young
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D013318:Stroke Volume; D013599:Systole