Prognostic Significance of Left Anterior Hemiblock in Patients With Suspected Coronary Artery Disease

Biagini, Elena; Elhendy, Abdou; Schinkel, Arend F. L.; Nelwan, S.P.; Rizzello, Vittoria; Domburg, Ron T. van; Rapezzi, Claudio; Rocchi, Guido; Simoons, Maarten L.; Bax, Jeroen J.; Poldermans, Don

doi:10.1016/j.jacc.2005.05.059

Cited by 32 publications

(11 citation statements)

References 21 publications

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“…Indeed, it has been demonstrated that the presence of different ECG abnormalities was independently associated with the development of major adverse cardiovascular events [26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Independent association of ECG abnormalities with microalbuminuria and renal damage in hypertensive patients without overt cardiovascular disease: data from Italy-Developing Education and awareness on MicroAlbuminuria in patients with hypertensive Disease study

Sciarretta¹,

Pontremoli

Rosei

et al. 2009

Journal of Hypertension

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This is the first large and systematic analysis of the relationship between detailed ECG abnormalities and MAU/chronic kidney disease in hypertensive patients without overt cardiovascular diseases. We report a significant and independent relationship between the presence of ECG abnormalities and renal damage in a preclinical stage of hypertension. Identification of ECG abnormalities in hypertension should prompt physicians to careful detection for renal damage, also in order to achieve an accurate risk stratification.

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Section: Discussionmentioning

confidence: 99%

Independent association of ECG abnormalities with microalbuminuria and renal damage in hypertensive patients without overt cardiovascular disease: data from Italy-Developing Education and awareness on MicroAlbuminuria in patients with hypertensive Disease study

Sciarretta¹,

Pontremoli

Rosei

et al. 2009

Journal of Hypertension

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“…38 -40 However, another study reported a slightly higher death rate among those patients with isolated LAH and myocardial infarction. 16 Likewise, in a recent study by Biagini et al 44 of 1187 patients with suspected coronary artery disease referred for stress testing, LAH, found in 159 patients, was associated with increased risk of cardiac death in a 6-year follow-up (P ϭ 0.004).…”

Section: Clinical Significance and Epidemiology Of Lahmentioning

confidence: 95%

Hemiblocks Revisited

2007

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Abstract-The trifascicular nature of the intraventricular conduction system and the concept of trifascicular block and hemiblock were described by Rosenbaum and his coworkers in 1968. Since then, anatomic, pathological, electrophysiological, and clinical studies have confirmed the original description and scarce advances have been developed on the subject. In the present study, we attempt to review and redefine reliable criteria for the electrocardiographic and vectorcardiographic diagnosis of left anterior and posterior hemiblock. One of the most important problems related to hemiblocks is that they may simulate or conceal the electrocardiographic signs of myocardial infarction or myocardial ischemia and may mask or simulate ventricular hypertrophy. Illustrative examples of these associations are shown to help the interpretation of electrocardiograms. The incidence and prevalence of the hemiblocks is presented based on studies performed in hospital patients and general populations. One of the most common causes of hemiblocks is coronary artery disease, and there is a particularly frequent association between anteroseptal myocardial infarction and left anterior hemiblock. The second most important cause is arterial hypertension, followed by cardiomyopathies and Lev and Lenègre diseases. The hemiblocks may also occur in aortic heart disease and congenital cardiopathies. Left anterior hemiblock is more common in men and increases in frequency with advancing age. Evidence is presented regarding the relationship of spontaneous closure of ventricular septal defects, which may explain the finding of this and other conduction defects in young populations. Isolated left anterior hemiblock is a relatively frequent finding in subjects devoid of evidence of structural heart disease. Conversely, isolated left posterior hemiblock is a very rare finding; its prognostic significance is unknown and is commonly associated with right bundle-branch block. The most remarkable feature of this association is that the prognosis is much more serious with a great propensity to develop complete atrioventricular block and Adams-Stoke seizures. Key Words: epidemiology Ⅲ heart septal defects Ⅲ myocardial infarction Ⅲ heart block Ⅲ bundle-branch block T hirty-eight years have elapsed since Rosenbaum et al published their seminal work that put together diverse previous observations and brought about a rational and complete analytic approach to the trifascicular concept of intraventricular conduction.These conclusive studies and an exhaustive review of the preceding knowledge of the subject were first published in the Spanish monograph, 1 and later a shorter updated version was presented to acquaint the English reader with the electrocardiographic manifestations and clinical correlation of the abnormal spread of ventricular excitation. 2 A series of articles published by the same authors between 1969 and 1973 also contributed to the expansion of the recognition of this research work. As stated by Herman N. Uhley, 3 this work triggered and infl...

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“…Additionally, this study involved a selected patient population that excluded patients with known CAD, hypertension, diabetes and heart failure. Similarly, another study by Biagini et al 11 reported that in 1187 ambulatory patients with suspected CAD who were referred for dobutamine stress test, LAHB (13%) was independently associated with an increased risk of cardiac death during a mean follow-up of 5 years. However, patients with previous MI were also excluded.…”

Section: Discussionmentioning

confidence: 79%

Clinical characteristics and outcomes of acute coronary syndrome patients with left anterior hemiblock

Zhang

Goodman

Steg

et al. 2014

Heart

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Prognostic Significance of Left Anterior Hemiblock in Patients With Suspected Coronary Artery Disease

Cited by 32 publications

References 21 publications

Independent association of ECG abnormalities with microalbuminuria and renal damage in hypertensive patients without overt cardiovascular disease: data from Italy-Developing Education and awareness on MicroAlbuminuria in patients with hypertensive Disease study

Independent association of ECG abnormalities with microalbuminuria and renal damage in hypertensive patients without overt cardiovascular disease: data from Italy-Developing Education and awareness on MicroAlbuminuria in patients with hypertensive Disease study

Hemiblocks Revisited

Clinical characteristics and outcomes of acute coronary syndrome patients with left anterior hemiblock

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