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Association of left bundle branch block with left ventricular structure and function in hypertensive patients with left ventricular hypertrophy: the LIFE study

Journal of Human Hypertension volume 18, pages 397–402 (2004)Cite this article

Abstract

Electrocardiographic (ECG) left bundle branch block (LBBB) is associated with left ventricular hypertrophy (LVH), but its relation to left ventricular (LV) geometry and function in hypertensive patients with ECG LVH is unknown. Echocardiograms were performed in 933 patients (548 women, mean age 66±7 years) with essential hypertension and LVH by baseline ECG in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. LBBB, defined by Minnesota code 7.1, was present in 47 patients and absent in 886 patients. Patients with and without LBBB were similar in age, gender, body mass index, blood pressure, prevalence of diabetes, and history of myocardial infarction. Despite similarly elevated mean LV mass (126±25 vs 124±26 g/m2) and relative wall thickness (0.41±0.07 vs 0.41±0.07, P=NS), patients with LBBB had lower LV fractional shortening (30±6 vs 34±6%), ejection fraction (56±10 vs 61±8%), midwall shortening (14±2 vs 16±2%), stress-corrected midwall shortening (90±13 vs 97±13%) (all P<0.001), and lower LV stroke index (38±7 vs 42±9 ml/m2) (P<0.05). Patients with LBBB also had reduced LV inferior wall and lower mitral E/A ratio (0.75±0.18 vs 0.87±0.38) (all P<0.05). The above univariate results were confirmed by multivariate analyses adjusted for gender, age, blood pressures, height, weight, body mass index, heart rate, and LV mass index. Among hypertensive patients at high risk because of ECG LVH, the presence of LBBB identifies individuals with worse global and regional LV systolic function and impaired LV relaxation without more severe LVH by echocardiography.

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Acknowledgements

We thank Paulette A Lyle for assistance with preparation of the manuscript.

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Authors and Affiliations

  1. Department of Medicine, Weill Medical College of Cornell University, New York, NY, USA

    Z B Li, P M Okin, J E Liu & R B Devereux

  2. Department of Medicine, Glostrup University Hospital, Glostrup, Denmark

    K Wachtell

  3. Haukeland University Hospital, Bergen, Norway

    E Gerdts

  4. Department of Cardiology, Helsinki University Central Hospital, Helsinki, Finland

    M S Nieminen

  5. Sahlgrenska University Hospital/Östra, Gothenburg, Sweden

    S Jern & B Dahlöf

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  1. Z B Li
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  2. K Wachtell
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  5. J E Liu
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  6. M S Nieminen
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  7. S Jern
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  8. B Dahlöf
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  9. R B Devereux
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Corresponding author

Correspondence to R B Devereux.

Additional information

This study was supported by Grant COZ 368 from Merck & Co., Inc., West Point, PA, USA. Drs. Devereux and Dahlöf receive occasional honoraria from Merck.

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Li, Z., Wachtell, K., Okin, P. et al. Association of left bundle branch block with left ventricular structure and function in hypertensive patients with left ventricular hypertrophy: the LIFE study. J Hum Hypertens 18, 397–402 (2004). https://doi.org/10.1038/sj.jhh.1001709

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