Evaluation of the predictive value of Gensini score on determination of severity of coronary artery disease in cases with left bundle branch block

Left bundle branch block (LBBB) is one of the features which predicts severe organic heart disease. In this study, we aimed to examine the predictive role of Gensini score as marker of severity of coronary artery disease (CAD) in patients with LBBB and its relationship with other CAD risk factors and complications. We have included patients who referred to our center for selective coronary angiography with transient and or permanent LBBB on their surface electrocardiography (ECG). Cases with pacemaker rhythm and known non-CAD related causes of LBBB pattern on surface ECG were excluded from this study. Demographic variables and clinical features were studied. To determine severity of CAD, Gensini score was measured. The relationship between presence of CAD and deteriorated ejection fraction has been demonstrated by previous works, but we found no association between severity of CAD and degree of ejection fraction deterioration. This might imply to the role of non-CAD factors toward reduction of ejection fraction. In cases with hypertension in the setting of LBBB, higher Gensini scores were seen regardless of ventricular ejection fraction. Thus, earlier screening for possible CAD in cases with LBBB and hypertension seems rational.