Effects of ventricular conduction block patterns on mortality in hospitalized patients with dilated cardiomyopathy: a single-center cohort study.
Ventricular conduction blocks (VCBs) are associated with poor outcomes in patients with known cardiac diseases. However, the prognostic implications of VCB patterns in dilated cardiomyopathy (DCM) patients need to be evaluated. The purpose of this study was to determine all-cause mortality in patients with DCM and VCB.



This cohort study included 1119 DCM patients with a median follow-up of 34.3 (19.5-60.8) months, patients were then divided into left bundle branch block (LBBB), right bundle branch block (RBBB), intraventricular conduction delays (IVCD) and narrow QRS groups. The all-cause mortality was assessed using Kaplan-Meier survival curves and Cox regression.



Of those 1119 patients, the all-cause mortality rates were highest in patients with IVCD (47.8, n = 32), intermediate in those with RBBB (32.9, n = 27) and LBBB (27.1 %, n = 60), and lowest in those with narrow QRS (19.9 %, n = 149). The all-cause mortality risk was significantly different between the VCB and narrow QRS group (log-rank χ2 = 51.564, P < 0.001). The presence of RBBB, IVCD, PASP ≥ 40 mmHg, left atrium diameter and NYHA functional class were independent predictors of all-cause mortality in DCM patients.



Our findings indicate that RBBB and IVCD at admission,but not LBBB, were independent predictors of all-cause mortality in patients with DCM.
Department of Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Hospital of the University of Electronic Science and Technology of China, Chengdu, Sichuan, 610072, China. lixiaoping0119@163.com.|Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China. lixiaoping0119@163.com.
Xiaoping
X
Li
Temperature and Inflammation Research Center, Key Laboratory of Colleges and Universities in Sichuan Province, Chengdu Medical College, Chengdu, 610500, People's Republic of China.
Rong
R
Luo
Department of Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Hospital of the University of Electronic Science and Technology of China, Chengdu, Sichuan, 610072, China.
Wei
W
Fang
Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, 55905, USA.
Xiaolei
X
Xu
Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China.
Guodong
G
Niu
Department of Cardiology, Lanzhou University Second Hospital, Lanzhou, Gansu, 730030, People's Republic of China.
Yixian
Y
Xu
Department of Medicine, Sahlgrenska University hospital/Östra hospital, Gothenburg, Sweden.
Michael
M
Fu
Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China. drhua@aliyun.com.
Wei
W
Hua
The Center of Heart Development, Key Lab of MOE for Development Biology and Protein Chemistry, College of Life Science, Hunan Normal University, Changsha, 410081, People's Republic of China.
Xiushan
X
Wu
D000200:Action Potentials; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D002423:Cause of Death; D016009:Chi-Square Distribution; D002681:China; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
Dilated cardiomyopathy; Prognosis; Pulmonary hypertension; Survival; Ventricular conduction block