[Prevalence of and predisposing factors for bundle branch block in patients starting dialysis]. / Análisis de la prevalencia y los factores predisponentes de los bloqueos de rama en los pacientes que inician diálisis.

INTRODUCTION AND OBJECTIVES: Although bundle branch block (BBB) is regarded as a frequent finding, data on its prevalence are scarce in the general population and nonexistent in patients on dialysis. The aims of this study were to determine the prevalence of complete BBB in patients starting dialysis, to identify factors associated with its presence and, secondarily, to explore its association with mortality and the occurrence of cardiovascular events. METHODS: The study involved patients who started dialysis at our institution between November 1, 2003 and December 31, 2006. All underwent cardiological evaluation at the start of treatment. The presence of BBB was determined and its relationship with clinical factors and biochemical and echocardiographic parameters was examined. Patients were followed up until November 30, 2007. RESULTS: The study included 211 patients (age 65.05+/-15.7 years; 56.4% male). Of these, 24 (11.4%) presented with BBB: 6 (2.8%) with left BBB and 18 (8.5%) with right BBB. Age (odds ratio [OR]=1.05; 95% confidence interval [CI], 1.008-1.113; P=.02) and body mass index (OR=1.12; 95% CI, 1.019-1.234; P=.02) were independently associated with BBB. During a mean follow-up period of 23.7+/-12.9 months, patients who presented with left BBB showed a clear trend towards a poorer outcome than those without a conduction defect. CONCLUSIONS: The prevalence of BBB was high in patients starting dialysis and greater than that observed in the general population. Its presence was independently associated with older age and obesity. During the mean follow-up period of 2 years, patients with left BBB demonstrated a trend towards a poor prognosis.

Análisis de la prevalencia y los factores predisponentes de los bloqueos de rama en los pacientes que inician diálisis / Prevalence of and Predisposing Factors for Bundle Branch Block in Patients Starting Dialysis

Introducción y objetivos. Aunque los bloqueos derama (BR) se consideran hallazgos frecuentes, la información sobre su prevalencia real en la población general es escasa, y es inexistente en los pacientes en diálisis. El objetivo es establecer la prevalencia del BR completo en la población que inicia diálisis y los factores relacionados con su aparición. Como análisis adicional, se explora su asociación con la mortalidad y con la aparición de un evento cardiovascular.Métodos. Se incluyó a los pacientes que iniciaron diálisis en nuestro centro entre el 1 de noviembre de 2003 y el 31 de diciembre de 2006. Todos fueron sometidos a valoración cardiológica al inicio de diálisis. Determinamos el BR y su relación con factores clínicos y parámetros ecocardiográficos y bioquímicos. Los pacientes fueron seguidos hasta el 30 de noviembre de 2007.Resultados. Se incluyó a 211 pacientes (media deedad, 65,05 ± 15,7 años; el 56,4% varones); 24 (11,4%)presentaban BR; 6 (2,8%), BR izquierda y 18 (8,5%), BRderecha. La mayor edad (odds ratio [OR] = 1,05; intervalode confianza [IC] del 95%, 1,008-1,113; p = 0,02) y el índice de masa corporal (OR = 1,12; IC del 95%, 1,019-1,234; p = 0,02) se relacionaron de forma independientecon el BR. Durante un seguimiento medio de 23,7 ± 12,9meses, hubo una clara tendencia a un peor pronóstico enlos pacientes con BR izquierda respecto a los que no tenían defecto de conducción.Conclusiones. Los pacientes que inician diálisis presentan una alta prevalencia de BR, superior a la de la población general. Mayor edad y obesidad se relacionan de forma independiente con que se produzca. Durante un seguimiento medio de 2 años, los pacientes con BR izquierda mostraron tendencia a un peor pronóstico

Introduction and objectives. Although bundle branchblock (BBB) is regarded as a frequent finding, data on its prevalence are scarce in the general population andnonexistent in patients on dialysis. The aims of this study were to determine the prevalence of complete BBB inpatients starting dialysis, to identify factors associated with its presence and, secondarily, to explore its association with mortality and the occurrence of cardiovascular events.Methods. The study involved patients who starteddialysis at our institution between November 1, 2003 andDecember 31, 2006. All underwent cardiologicalevaluation at the start of treatment. The presence of BBBwas determined and its relationship with clinical factorsand biochemical and echocardiographic parameters wasexamined. Patients were followed up until November 30,2007.Results. The study included 211 patients (age65.05±15.7 years; 56.4% male). Of these, 24 (11.4%)presented with BBB: 6 (2.8%) with left BBB and 18 (8.5%)with right BBB. Age (odds ratio [OR]=1.05; 95%confidence interval [CI], 1.008-1.113; P=.02) and bodymass index (OR=1.12; 95% CI, 1.019-1.234; P=.02) wereindependently associated with BBB. During a meanfollow-up period of 23.7±12.9 months, patients whopresented with left BBB showed a clear trend towards apoorer outcome than those without a conduction defect.Conclusions. The prevalence of BBB was high inpatients starting dialysis and greater than that observed in the general population. Its presence was independently associated with older age and obesity. During the mean follow-up period of 2 years, patients with left BBB demonstrated a trend towards a poor prognosis