Department of Cardiology, Cardiovascular Research Institute, Hubei Key Laboratory of Cardiology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, China.
Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, China.
Ann Noninvasive Electrocardiol. 2022 Jan;27(1):e12883. doi: 10.1111/anec.12883. Epub 2021 Jul 14.
Right bundle-branch block (RBBB) and left bundle-branch block (LBBB) play a role in the pathogenesis and progression of coronary artery disease (CAD). However, the clinical features and the severity of coronary artery disease associated with different subtypes of bundle-branch block, according to time of new appearance, is not well characterized in patients with no known CAD.
We retrospectively analyzed data pertaining to consecutive patients with RBBB or LBBB who underwent coronary angiography. The severity of coronary lesions was evaluated using the SYNTAX score. The differential effect of new-onset RBBB, old RBBB, new-onset LBBB, and old LBBB on the severity of CAD and its association with clinical characteristics was quantified. Multivariate logistic regression analysis was performed to evaluate the effect of RBBB and LBBB on the degree of coronary atherosclerosis in patients without known CAD.
Out of the 243 patients, 72 patients had old LBBB, 37 had new-onset LBBB, 93 patients had old RBBB, and 41 patients had new-onset RBBB. On univariate analysis, age, systolic blood pressure, diastolic blood pressure, creatinine, serum glucose, and glycosylated hemoglobin level were associated with high SYNTAX score (p < .05 for all). Patients in the new-onset RBBB, old RBBB, new-onset LBBB, and old LBBB groups showed significant differences in baseline characteristics and coronary atherosclerosis (p < .05 for all). However, there were no significant between-group differences with respect to the degree of coronary atherosclerosis as assessed by SYNTAX score.
New-onset RBBB, old RBBB, new-onset LBBB, and old LBBB were not associated with the severity of coronary lesions as assessed by SYNTAX score in patients without known CAD.
右束支传导阻滞（RBBB）和左束支传导阻滞（LBBB）在冠状动脉疾病（CAD）的发病机制和进展中起作用。然而，在没有已知 CAD 的患者中，根据新出现的时间，不同类型的束支传导阻滞的临床特征和冠状动脉疾病的严重程度尚不清楚。
我们回顾性分析了连续接受冠状动脉造影的 RBBB 或 LBBB 患者的数据。使用 SYNTAX 评分评估冠状动脉病变的严重程度。量化新出现的 RBBB、陈旧的 RBBB、新出现的 LBBB 和陈旧的 LBBB 对 CAD 严重程度的差异影响及其与临床特征的关系。进行多变量逻辑回归分析以评估 RBBB 和 LBBB 对无已知 CAD 患者冠状动脉粥样硬化程度的影响。
在 243 名患者中，72 名患者有陈旧的 LBBB，37 名患者有新出现的 LBBB，93 名患者有陈旧的 RBBB，41 名患者有新出现的 RBBB。在单因素分析中，年龄、收缩压、舒张压、肌酐、血清葡萄糖和糖化血红蛋白水平与高 SYNTAX 评分相关（p<.05）。新出现的 RBBB、陈旧的 RBBB、新出现的 LBBB 和陈旧的 LBBB 组患者在基线特征和冠状动脉粥样硬化方面存在显著差异（p<.05）。然而，根据 SYNTAX 评分评估，各组间的冠状动脉粥样硬化程度没有显著差异。
在无已知 CAD 的患者中，新出现的 RBBB、陈旧的 RBBB、新出现的 LBBB 和陈旧的 LBBB 与 SYNTAX 评分评估的冠状动脉病变严重程度无关。
