The left bundle branch block (LBBB) is associated with ventricular septal mid-wall fibrosis (SMF) in patients with dilated cardiomyopathy (DCM). However, whether LBBB is also associated with SMF in patients with preserved left ventricular ejection fraction (LVEF) remains unclear. We performed a retrospective study of 210 patients with preserved LVEF (male, = 116; female, = 94; mean age, 44 ± 17 years). LBBB was defined as QRS duration ≥140 ms for men or ≥ 130 ms for women, QS or rS in V-V, mid-QRS notching or slurring in at least two leads (V, V, V, V, I, and aVL). SMF determined by late gadolinium-enhancement cardiovascular magnetic resonance was defined as stripe-like or patchy mid-myocardial hyper-enhancement in the interventricular septal segments. SMF was detected in 24.8% (52/210) of these patients. The proportion of patients with SMF with LBBB was higher than the proportion of patients with SMF without LBBB (58.3% vs. 20.4%; < 0.001). In the forward multivariate logistic analysis, LBBB (, 4.399; 95% , 1.774–10.904; = 0.001) and age (, 1.028; 95% , 1.006–1.051; = 0.011) were independently associated with SMF. The presence of LBBB showed a sensitivity of 27%%, specificity of 94%, positive predictive value of 58%%, and negative predictive value of 80% for the detection of SMF. LBBB was significantly associated with SMF in hospitalized patients with preserved LVEF. Screening with a resting 12‑lead ECG may help to identify patients who are at a high risk of the presence of SMF.

中文翻译：

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左心室射血分数保留患者左束支传导阻滞与室间隔中壁纤维化的相关性

扩张型心肌病（DCM）患者的左束支传导阻滞（LBBB）与室间隔中壁纤维化（SMF）相关。然而，对于左心室射血分数 (LVEF) 保留的患者，LBBB 是否也与 SMF 相关仍不清楚。我们对 210 名 LVEF 保留的患者（男性 = 116；女性 = 94；平均年龄，44 ± 17 岁）进行了回顾性研究。LBBB 定义为男性 QRS 持续时间≥140 ms，女性 QRS 持续时间≥130 ms，VV 中的 QS 或 rS，至少两个导联（V、V、V、V、I 和 aVL）中 QRS 中切迹或模糊。通过后期钆增强心血管磁共振测定的 SMF 被定义为室间隔段中的条纹状或斑片状心肌中部过度增强。其中 24.8% (52/210) 的患者检测到 SMF。伴 LBBB 的 SMF 患者比例高于不伴 LBBB 的 SMF 患者比例（58.3% vs. 20.4%；< 0.001）。在正向多变量 Logistic 分析中，LBBB（4.399；95%，1.774–10.904；= 0.001）和年龄（1.028；95%，1.006–1.051；= 0.011）与 SMF 独立相关。LBBB 的存在对 SMF 的检测的敏感性为 27%%，特异性为 94%，阳性预测值为 58%%，阴性预测值为 80%。在 LVEF 保留的住院患者中，LBBB 与 SMF 显着相关。使用静息 12 导联心电图进行筛查可能有助于识别存在 SMF 高风险的患者。