Study On The Relationship Between Patients’ Cardiac Function And Different Types Of Bundle Branch Block

Bundle branch block is a kind of clinical common abnormal electrocardiogram.It is the arrhythmia caused by abnormal cardiac conduction system.When the partial or complete obstruction of his bundle and the below bifurcation sites of the cardiac tract of the cardiac conduction system(Who consists of the sinoatrial node,the bundle of nodes,the atrioventricular node,his bundle,the left / right bundle branch and the branches and the Purkinje fiber)happens,ECG will be bundle branch block(bundle branch block,BBB)graphics.Bundle branch block as bundle block,bundle branch block including left bundle branch block(left bundle branch block,LBBB)and right bundle branch block(right bundle branch block,RBBB);With the population aging of our country,coronary heart disease,hypertension,diabetes and other more common diseases,the incidence and prevalence of heart failure is gradually increased.Heart failure has been one of the most important cardiovascular diseases in the twenty-first Century.Heart failure is a serious and terminal stage in the development of various heart diseases.Because of the high prevalence of heart failure,mortality,complex condition,poor prognosis and medical expenses caused by repeated treatment and other reasons,it has brought a heavy burden to the country,society and family;In 2014,the definition of heart failure in the Chinese Medical Association of heart failure group was: the main clinical manifestations of heart failure were dyspnea,fatigue and fluid retention;It is a complex set of clinical syndromes caused by abnormal ventricular filling or ejection capacity due to abnormal cardiac structure or function.The study found that: when accompanied by left bundle branch block,left ventricular electrical activation is abnormal;when with right bundle branch block,right ventricular free wall and even left ventricular wall motions abnormality.Delayed excitation of the local myocardium,abnormal ventricular systolic synchrony,ventricular systolic or diastolic dysfunction,resulting in decreased left ventricular function.When there is complete left bundle branch block or right bundle branch block,the ventricular systolic asynchrony is not synchronized,and the heart function is decreased because of the prolongation of QRS wave group.It is generally believed that left bundle branch block can affect cardiac function to a greater extent than right bundle branch block.Left bundle branch block is more likely to independently predict the risk of cardiovascular events or left bundle branch block is more severe than right bundle branch block in patients with heart disease or prognosis.Even before 1980 s,the right bundle branch block was generally considered to be a mild and well-developed arrhythmia,however,recent studies show that this is not the case.Domestic and international studies have shown that complete right bundle branch block may also increase the risk of all-cause death or cardiovascular death.Previous studies have focused on the effects of left bundle branch block on cardiac function,but there is little research on the relationship between right bundle branch block and cardiac function.The purpose of this study was to compare the differences of the effects of different types of bundle branch block on the cardiac function in the same QRS time limit and the different QRS duration of the same type.Purpose:The NT-BNP of two groups of patients with bundle branch block,the QRS wave duration,LVEF(left ventricular ejection fraction(FS),left ventricular fractional shortening),E/A,heart rate and other related indicators for comparative analysis,to investigate the differences of cardiac function in patients with different types of bundle branch block and different duration of QRS.Methods:A total of 281 patients with bundle branch block in cardiovascular department of the Chaoyang Central Hospital from September 2014 to February 2016 were collected.In this research,there were 151 males and 130 females with an average age of 68.68 + /-12.47 years old,180 patients with left bundle branch block and right bundle branch block in 105 case,To record indexes,such as age,sex,type of bundle branch block,QRS time limit,LVEF,FS,BNP,etal for comparison analysis.According to the type of bundle branch block,281 patients with bundle branch block were divided into left bundle branch block(LBBB)group(group A,n = 102)and right bundle branch block(RBBB)group(group B,n = 179).On the basis of the QRS duration,group A and group B were divided into group A1(n= 47)or B1(n= 138)(QRS duration <150ms)and group A2(n= 55)or B2(n= 41)group(equal to or more than 150ms).The differences of the related indexes of cardiac function which were between patients with different types of bundle branch block and with different QRS duration in normal cardiac ultrasound and electrocardiogram and something else were compared;Results:1 Comparison of two groups of patients with bundle branch block:There was no significant difference in gender,age,height and weight between the two groups of patients with A and B(P>0.05).2 The indexes of Cardiac function in patients with different types of bundle branch block :there was a significant difference between the two groups(A,B)on systolic function index(left ventricular ejection fraction(LVEF),left ventricular short axis shortening(FS))and BNP(P< 0.05);There was no significant difference in LVEF,FS between group B1 and group B2(P> 0.05).There was significant difference in BNP between group B1 and group B2,group A1 and group B1(P< 0.05).There was no significant difference in diastolic function index(E/A)between group A and group B(P> 0.05).There was no significant difference in heart rate(HR)of group A and B(P > 0.05).Conclusion:The heart function in the group of RBBB block is better than group of LBBB.As QRS duration prolongs,the cardiac systolic function of patients with LBBB decreases more significantly.