112例左束支传导阻滞患者冠状动脉造影结果及临床特点分析

目的探讨左束支传导阻滞(LBBB)患者冠状动脉造影结果及临床特点。方法分析112例具有冠状动脉造影结果的LBBB患者的临床资料,冠状动脉至少1支主要分支管腔狭窄>50%为冠心病的诊断标准。结果 112例患者中,46例符合冠心病诊断标准(41.1%),其中24例为冠状动脉单支病变(52.2%),14例为冠状动脉2支病变(30.4%),8例为左主干病变或者3支病变(17.4%)。LVEF>40%的92例患者中,有左主干病变或者3支病变的仅为5例(5.4%);20例LVEF≤40%的患者中,则有3例(15.0%)为左主干病变或者3支病变。结论冠心病为LBBB的第1位病因,依次为高血压、糖尿病、扩张型心肌病及单纯LBBB;诊断为冠心病的LBBB患者中以冠状动脉单支病变为主,因此,冠心病的严重程度与LBBB没有直接关系。LBBB伴有左心室收缩功能不全的患者中左主干或者3支病变的发生率明显高于不伴有左心室收缩功能不全的患者。

Analysis of coronary angiography results and clinical features in 112 cases of complete left bundle branch block

Objective To explore the results of coronary angiography and clinical characteristics in patients with complete left bundle branch block (LBBB). Methods Clinical materials of 112 patients with LBBB and receiving.coronary angiography were analyzed. Diagnosis criterion for coronary artery disease(CAD) was that at least one major branch of coronary artery had stenosis more than 50%. Results Coronary angiogram revealed that 46 patients(41.1%) suffered from CHD,of whom,24(52.2%) had single vessel disease,14 (30.4%)had double vessel disease,8(17.4%)had left main coronary artery disease or triple vessel disease. Of 92 patients whose LVEF>40% ,only 5(5.4%) had left main coronary artery disease or triple vessel disease. Of 20 patients whose LVEF≤40% ,3(15.0%) had left main coronary artery disease or triple vessel disease. Conclusions The first etiology of LBBB was CAD, followed by hypertension, diabetes, dilated cardiomyopathy,and simple LBBB. Therefore,coronary arteriography is necessary for diagnosis of CAD in patients with LBBB. In 46 LBBB patients with CAD, single vessel disease was the major type, and for this reason,the severity of CAD had no direct relation with LBBB. Morbidity of left main coronary artery disease or triple vessel disease in LBBB with left ventricular systolic function failure was higher than that in LBBB with normal left ventricular systolic function.