Studying Angiographic Disease Pattern In Patients With Left Bundle Branch Block Undergoing Coronary Angiography

Objective: To observe the relationship between left bundle branch block (LBBB) and coronary artery disease (CAD) severity using the SYNTAX score and to evaluate the impact of CAD severity on left ventricular ejection fraction (LVEF) in patients undergoing coronary angiography. Methods: A prospective, comparative, cross-sectional study was conducted at the Rawalpindi Institute of Cardiology. Patients with symptomatic LBBB, defined by European Society of Cardiology criteria, who underwent coronary angiography were included. Echocardiography was used to assess LVEF, dividing patients into two groups: Group A (LVEF <45%) and Group B (LVEF ≥45%). CAD severity was evaluated using the SYNTAX score, categorising patients into low (0–22), intermediate (23–32), and high (>32) groups. Statistical analysis was performed using SPSS version 24, with a p-value of <0.05 considered significant. Results: A total of 140 patients were included (57% male, mean age 57.14 ± 10.42 years). Hypertension (60%) and multi-risk factors (50%) were predominant. Angiography revealed left anterior descending artery (LAD) involvement in 60% of patients. Group A exhibited significantly higher intermediate and high SYNTAX scores than Group B (p<0.001). Male patients and those with multiple risk factors were more likely to show abnormal angiographic findings (p<0.05). LAD involvement was notably higher in patients with high SYNTAX scores (p=0.002). Conclusion: Patients with LBBB show a strong correlation with severe CAD and reduced LVEF, highlighting the need for routine coronary angiography in high-risk cases. The study emphasizes the importance of addressing cardiovascular risks aggressively in this population to improve clinical outcomes.