Predicting Long-term Mortality In Acute Heart Failure In Patients With Complete Right Bundle Branch Block

Background:Although there are so many established prognostic markers for acute heart failure(AHF),the predictive value of right bundle branch block(RBBB)in hospitalized patients with AHF is still unknown.The aim of the present study is to investigate the relationship between the complete right bundle branch block(CRBBB)patterns and long-term mortality of AHF in Chinese patients.Methods:We enrolled 346 patients who had been hospitalized for AHF in cardiovascular department of the First Affiliated Hospital of Nanjing Medical University,from March 2012 to February 2015.The Primary endpoint was all-cause mortality during 18-months follow up.The patients were divided into two groups,including the death group and the survivor group.The clinical data and the results of the admission examination were collected,and then made statistical analysis.Results:?39 participants(11.3%)among the 346 patients dropped out,73 patients(23.8%)dead at the end of this study.?Among the 307 patients,CRBBB was present in 35 patients(11.4%),including 18 patients in the death group and 17 patients in the survivor group,which was statistically significant(P<0.001).?Kaplan-Meier analysis revealed that patients with CRBBB were at higher risk of death when compared with patients without CRBBB.?The calculation shows that the specificity of CRBBB for predicting the prognosis of patients with AHF was up to 92.7%(95%CI 88.6%-95.7%),and the sensitivity was 24.7%(95%CI 15.3%-36.1%).? In COX stepwise regression analysis(forward),after multivariable adjustment,CRBBB was associated with over two-fold increase in mortality.(Hazard ratio(HR)3.912 95%CI 2.208-6.933).Conclusions:CRBBB seems to be a promising predictor of long-term mortality in patients with AHF.