{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T15:23:07Z","timestamp":1789226587097,"version":"build-2803163510"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>We evaluated the risk of incident heart failure (HF) associated with bundle-branch blocks (BBBs) in postmenopausal women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>Cox\u2019s regression was used to evaluate hazard ratios with 95% confidence intervals for HF among 65\u2009975 participants of the Women\u2019s Health Initiative (WHI) study during an average follow-up of 14 years. BBBs observed in 1676 women at baseline were categorized into left, right, and indetermined-type BBBs (LBBB, RBBB, and intraventricular conduction defect, respectively). Compared with women with no BBB, LBBB, and intraventricular conduction defect were strong predictors of incident HF in multivariable-adjusted risk models (hazard ratio, 3.79; confidence interval, 2.95\u20134.87 for LBBB and hazard ratio, 3.53; confidence interval, 2.14\u20135.81 for intraventricular conduction defect). RBBB was not a significant predictor of incident HF in multivariable-adjusted risk model, but the combination of RBBB and left anterior fascicular block was a strong predictor (hazard ratio, 2.96; confidence interval, 1.77\u20134.93). QRS duration was an independent predictor of incident HF only in LBBB, with more pronounced risk at QRS \u2265140 ms than at &lt;140 ms. QRS nondipolar voltage (RNDPV) was an independent predictor in both RBBB and LBBB and, in addition, in LBBB, QRS\/STT angle and ST J-point depression in aVL were independent predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>LBBB, intraventricular conduction defect, and RBBB combined with left anterior fascicular block are strong predictors of incident HF in multivariable-adjusted risk models, but RBBB is not a significant predictor. QRS duration \u2265140 ms may warrant consideration in LBBB as an indication for further diagnostic evaluation for possible therapeutic and preventive action.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT00000611.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.113.000217","type":"journal-article","created":{"date-parts":[[2013,5,31]],"date-time":"2013-05-31T21:33:14Z","timestamp":1370035994000},"page":"655-661","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Different Patterns of Bundle-Branch Blocks and the Risk of Incident Heart Failure in the Women\u2019s Health Initiative (WHI) Study"],"prefix":"10.1161","volume":"6","author":[{"given":"Zhu-ming","family":"Zhang","sequence":"first","affiliation":[{"name":"From the Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention (Z.-m.Z., P.M.R., E.Z.S., R.J.P.) and Department of Epidemiology and Prevention (M.V.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (J.E.M.); Division of Cardiology, George Washington University, Washington, DC (L.W.M.); and Stanford University Medical Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pentti M.","family":"Rautaharju","sequence":"additional","affiliation":[{"name":"From the Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention (Z.-m.Z., P.M.R., E.Z.S., R.J.P.) and Department of Epidemiology and Prevention (M.V.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (J.E.M.); Division of Cardiology, George Washington University, Washington, DC (L.W.M.); and Stanford University Medical Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsayed Z.","family":"Soliman","sequence":"additional","affiliation":[{"name":"From the Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention (Z.-m.Z., P.M.R., E.Z.S., R.J.P.) and Department of Epidemiology and Prevention (M.V.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (J.E.M.); Division of Cardiology, George Washington University, Washington, DC (L.W.M.); and Stanford University Medical Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JoAnn E.","family":"Manson","sequence":"additional","affiliation":[{"name":"From the Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention (Z.-m.Z., P.M.R., E.Z.S., R.J.P.) and Department of Epidemiology and Prevention (M.V.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (J.E.M.); Division of Cardiology, George Washington University, Washington, DC (L.W.M.); and Stanford University Medical Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa W.","family":"Martin","sequence":"additional","affiliation":[{"name":"From the Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention (Z.-m.Z., P.M.R., E.Z.S., R.J.P.) and Department of Epidemiology and Prevention (M.V.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (J.E.M.); Division of Cardiology, George Washington University, Washington, DC (L.W.M.); and Stanford University Medical Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Perez","sequence":"additional","affiliation":[{"name":"From the Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention (Z.-m.Z., P.M.R., E.Z.S., R.J.P.) and Department of Epidemiology and Prevention (M.V.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (J.E.M.); Division of Cardiology, George Washington University, Washington, DC (L.W.M.); and Stanford University Medical Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Vitolins","sequence":"additional","affiliation":[{"name":"From the Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention (Z.-m.Z., P.M.R., E.Z.S., R.J.P.) and Department of Epidemiology and Prevention (M.V.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (J.E.M.); Division of Cardiology, George Washington University, Washington, DC (L.W.M.); and Stanford University Medical Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald J.","family":"Prineas","sequence":"additional","affiliation":[{"name":"From the Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention (Z.-m.Z., P.M.R., E.Z.S., R.J.P.) and Department of Epidemiology and Prevention (M.V.), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; Division of Preventive Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (J.E.M.); Division of Cardiology, George Washington University, Washington, DC (L.W.M.); and Stanford University Medical Center,..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.hyp.0000217141.20163.23"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.05.024"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2009.01440.x"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(96)00160-9"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi580"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.06.018"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs291"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.537415"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-2456(97)00078-0"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(03)00042-5"},{"key":"e_1_3_4_12_2","first-page":"111","volume-title":"The Minnesota Code Manual of Electrocardiographic Findings","author":"Prineas RJ","year":"2009","unstructured":"Prineas RJ, Crow RS, Zhang ZM. 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