Severity of Coronary Artery Disease on Patients with Left Bundle Branch Block | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 14 October 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.422590.4176 | ||
| Authors | ||
| Asmaa Abd El-karim Kenawy; Hossam Abd El-karim Ismail Mohamed Magar* ; Morad Beshay Mina; Ghada Mahmoud Sultan | ||
| Department of Cardiology, Faculty of Medicine, Menoufia University, Menoufia, Egypt. | ||
| Abstract | ||
| Background: Left bundle branch block (LBBB) is linked to reduced ventricular function elevated risk of morbidity and death, particularly when related to coronary artery disease (CAD).This research aimed to evaluate the predictive value of the existence of left bundle branch block on surface electrocardiogram (ECG) in determining the severity of coronary artery disease, evaluated through Synergy Between Percutaneous Coronary Intervention with Taxus Cardiac Surgery (SYNTAX) score. Methods: This prospective research involved 80 CAD cases undergoing coronary angiography: 40 cases with LBBB and 40 cases with non-LBBB on baseline ECG, echocardiographic and laboratory data were recorded. The SYNTAX score has been used to evaluate the severity of CAD. Results: Patients with LBBB are associated statistically significantly with diabetes and prior CABGE. Echocardiography revealed increased LVEDD, LVESD, and reduced ejection fraction in the LBBB group. QRS duration in LBBB cases was positively correlated with SYNTAX score. LDL, RBS, and SYNTAX score were additionally significantly elevated in this group. QRS duration was an independent predictor of severe CAD in LBBB patients (OR = 1.233, p-value = 0.003), with 87.5% sensitivity 88% specificity at 145 ms cut-off (AUC = 0.874, p-value below 0.001) for predicting high SYNTAX score (≥32). Conclusion: In LBBB patients, QRS duration related SYNTAX score independently predicted CAD severity. QRS duration more than 145 ms effectively identified severe CAD.A QRS duration above 145 milliseconds demonstrated moderate to high accuracy in identifying severe CAD, suggesting its promising predictive value as a simple, non-invasive marker for assessing disease severity in patients with LBBB. | ||
| Keywords | ||
| Left bundle branch block; Coronary artery disease; QRS duration; SYNTAX score | ||
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