The authors prospectively investigated whether left bundle branch block (LBBB) and myocardial degradation as indicated by elevated troponin T (tnT) predict the phenomenon of systolic conversion to low ejection fraction (EF .40%) in patients with nonsignificant coronary disease and heart failure with preserved systolic function (HFPSF) (initial EF > 40%). Thirty consecutive patients with HFPSF were included and followed over a 4-year interval. A follow-up EF assessment was performed in 25 patients. Six of 15 patients with tnT .0.01 ng/mL demonstrated systolic conversion to low EF on follow-up, while none of the 10 patients with tnT < 0.01 ng/mL experienced this phenomenon (P=.03). Five of the 6 converters presented with LBBB, while only 1 of the 19 nonconverters had this abnormality (P=.0007). Four of the 6 converters had an initial EF > 50%. Myocardial degradation and LBBB predicted systolic conversion in HFPSF patients with nonsignificant coronary disease. Congest Heart Fail. 2008;14:192.196. c2008 Le Jacq.
ASJC Scopus subject areas
- Emergency Medicine
- Cardiology and Cardiovascular Medicine