Comprehensive Clinical and Echocardiographic Evaluation of Patients with Complete Left Bundle Branch Block at a Tertiary Care Centre

Background: Left Bundle Branch Block (LBBB) is a significant cardiac conduction abnormality signifying delayed electrical activation of the left ventricle. This electromechanical dyssynchrony is a key pathophysiological driver of adverse cardiac remodeling and functional impairment. While LBBB is strongly associated with major cardiovascular diseases, its direct relationship with specific clinical profiles and the severity of echocardiographic abnormalities requires detailed, granular investigation.

Objective: To comprehensively analyze the clinical and echocardiographic profile of patients with complete LBBB and to determine the association between patient comorbidities and the severity of observed cardiac dysfunction.

Methods: This single-center, cross-sectional observational study was conducted over 18 months at Al-Ameen Medical College Hospital, a tertiary care center in Vijayapura. One hundred patients with ECG-confirmed complete LBBB were prospectively enrolled. All participants underwent a detailed clinical evaluation and a comprehensive 2D echocardiographic assessment to evaluate cardiac structure, systolic function, and diastolic function. Statistical analysis was performed using SPSS, with the Chi-square test used to identify significant associations.

Results: The mean participant age was 60.99 ± 10.91 years, with a significant male preponderance (62%). Prevalent comorbidities included type 2 diabetes (62%) and hypertension (56%). Fatigue (22%) and dyspnea (19%) were the most common symptoms. A striking 90% of patients exhibited echocardiographic abnormalities. Key findings included left ventricular hypertrophy (LVH) with varying grades of diastolic dysfunction and dilated cardiomyopathy (DCM). The severity of DCM was significantly associated with male gender (p=0.01), coronary artery disease (p=0.03), diabetes (p=0.03), and hypertension (p=0.006). These nonspecific symptoms can often be mistakenly attributed to age-related decline, making it crucial to investigate underlying causes such as LBBB, especially in the presence of cardiovascular risk factors.

Conclusion: LBBB is a marker of substantial underlying cardiac pathology, predominantly LVH, diastolic dysfunction, and DCM. The strong, statistically significant association between the severity of these conditions and the presence of common cardiovascular comorbidities underscores the need for aggressive risk factor management. Echocardiography is an indispensable tool for risk stratification in LBBB patients, guiding targeted therapies to prevent progression to heart failure.