PMID- 30224030
OWN - NLM
STAT- MEDLINE
DCOM- 20190311
LR  - 20190311
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 269
DP  - 2018 Oct 15
TI  - Prognostic significance of left anterior fascicular block and its relation with
      coronary artery disease in old patients based on 570 autopsy cases.
PG  - 1-6
LID - S0167-5273(17)36414-8 [pii]
LID - 10.1016/j.ijcard.2018.06.069 [doi]
AB  - BACKGROUND: Left Anterior Fascicular Block (LAFB) occurs frequently among the
      elderly, and have a correlation with coronary artery disease (CAD), yet
      controversies regarding its clinical significance still remain. METHODS: We
      carried on a retrospective study involving 92 LAFB and 478 non-LAFB patients, in 
      which anatomic, clinical and electrocardiographic characteristics were compared. 
      RESULTS: LAFB subjects had more pathological CAD (66.3% vs 54.6%, P=0.039),
      myocardial infarction (MI) (53.3% vs 37.9%, P=0.007) and myocarditis (5.4% vs
      1.7%, P=0.043). Among the LAFB group, 58.1% of patients with CAD and 30.2% of
      patients with MI were clinically misdiagnosed, while 42.9% of patients with MI
      were clinically missed. Logistic regression showed CAD had no independent
      relevance with LAFB. LAFB subjects displayed heavier hearts [(451.1+/-101.3)g vs 
      (407.1+/-102.3)g, P<0.001], thicker left ventricular walls [(1.6+/-0.4)cm vs
      (1.4+/-0.3)cm, P=0.001]. Kaplan-Meier survival analysis indicated significant
      differences in long-term survival time (chi(2)=12.223, P<0.001) and cardiac
      mortality (chi(2)=20.982, P<0.001) between LAFB and non-LAFB group. Cox
      multivariate analysis demonstrated LAFB was an independent risk factor of
      all-cause death (HR=1.552, 95% CI=1.208-1.994, P=0.001) and cardiac death
      (HR=2.287, 95% CI=1.545-3.386, P<0.001). The major death cause of LAFB was
      cardiac death (46.7%), including more MI (28.3% vs 13.4%, P=0.008), myocarditis
      (4.3% vs 1.0%, P=0.042) and cardiac rupture (6.7% vs 1.9%, P=0.022). CONCLUSIONS:
      LAFB subjects had more pathological CAD and MI, but LAFB was not an independent
      relevant factor of CAD. LAFB lowered the accuracy to clinically diagnose CAD.
      LAFB patients gained heavier hearts, thicker left ventricular walls, and suffered
      increased risk of death and cardiac death.
CI  - Copyright (c) 2018. Published by Elsevier B.V.
FAU - Ding, Siyin
AU  - Ding S
AD  - Department of Cardiology, Beijing Hospital, National Center of Gerontology,
      China, No.1 Dahua Road, Dong Dan, Beijing 100730, PR China.
FAU - Chai, Ke
AU  - Chai K
AD  - Department of Cardiology, Beijing Hospital, National Center of Gerontology,
      China, No.1 Dahua Road, Dong Dan, Beijing 100730, PR China.
FAU - Li, Yingying
AU  - Li Y
AD  - Department of Cardiology, Beijing Hospital, National Center of Gerontology,
      China, No.1 Dahua Road, Dong Dan, Beijing 100730, PR China.
FAU - Fang, Fang
AU  - Fang F
AD  - Department of Pathology, Beijing Hospital, National Center of Gerontology, China,
      No.1 Dahua Road, Dong Dan, Beijing 100730, PR China.
FAU - Yang, Jiefu
AU  - Yang J
AD  - Department of Cardiology, Beijing Hospital, National Center of Gerontology,
      China, No.1 Dahua Road, Dong Dan, Beijing 100730, PR China.
FAU - Wang, Hua
AU  - Wang H
AD  - Department of Cardiology, Beijing Hospital, National Center of Gerontology,
      China, No.1 Dahua Road, Dong Dan, Beijing 100730, PR China. Electronic address:
      wanghua2764@bjhmoh.cn.
LA  - eng
PT  - Journal Article
DEP - 20180620
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
CIN - Int J Cardiol. 2018 Oct 15;269:31-32. PMID: 30045821
MH  - Aged
MH  - Aged, 80 and over
MH  - Autopsy
MH  - Bundle-Branch Block/*pathology
MH  - Cohort Studies
MH  - Coronary Artery Disease/*pathology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Autopsy
OT  - Coronary artery disease
OT  - Left anterior fascicular block
OT  - Prognosis
EDAT- 2018/09/19 06:00
MHDA- 2019/03/12 06:00
CRDT- 2018/09/19 06:00
PHST- 2017/11/02 00:00 [received]
PHST- 2018/06/05 00:00 [revised]
PHST- 2018/06/18 00:00 [accepted]
PHST- 2018/09/19 06:00 [entrez]
PHST- 2018/09/19 06:00 [pubmed]
PHST- 2019/03/12 06:00 [medline]
AID - S0167-5273(17)36414-8 [pii]
AID - 10.1016/j.ijcard.2018.06.069 [doi]
PST - ppublish
SO  - Int J Cardiol. 2018 Oct 15;269:1-6. doi: 10.1016/j.ijcard.2018.06.069. Epub 2018 
      Jun 20.