Department Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Am J Cardiol. 2021 Nov 1;158:30-36. doi: 10.1016/j.amjcard.2021.07.042. Epub 2021 Aug 27.
Limited data exist regarding the association between right bundle branch block (RBBB) and subclinical coronary atherosclerosis. This study investigated the influence of RBBB on subclinical coronary atherosclerosis detected by coronary computed tomographic angiography (CCTA) in an asymptomatic population. We retrospectively analyzed 7,205 asymptomatic individuals (mean age 54.4 ± 7.9 years and 4,695 men [65.2%]) with no prior history of coronary artery disease who voluntarily underwent CCTA and 12-lead electrocardiographic evaluation as part of a general health examination. The degree and extent of subclinical coronary atherosclerosis were evaluated by CCTA, and ≥50% diameter stenosis was defined as significant. The association between RBBB and subclinical coronary atherosclerosis was determined by logistic regression and propensity score matching analyses. Of study participants, 116 (1.6%) had RBBB. After adjustment for cardiovascular risk factors, there were no statistically significant differences in the adjusted odds ratios of RBBB for any atherosclerotic plaque (0.87, 95% confidence interval [CI] 0.57 to 1.32), calcified plaque (0.78, 95% CI 0.51 to 1.19), noncalcified plaque (1.44, 95% CI 0.77 to 2.69), mixed plaque (1.12, 95% CI 0.52 to 2.39), and significant coronary artery stenosis (0.92, 95% CI 0.48 to 1.74). Similarly, in the 5: 1 propensity score-matched population (n = 696), there were no statistically significant differences in the odds ratios for any subclinical coronary atherosclerosis between participants with and without RBBB (p for all >0.05). In conclusion, through this large cross-sectional study of asymptomatic individuals who underwent CCTA and electrocardiography evaluation, individuals with RBBB were not associated with an increased risk of subclinical coronary atherosclerosis compared with those without RBBB.
关于右束支传导阻滞 (RBBB) 与亚临床冠状动脉粥样硬化之间的关联，现有数据有限。本研究旨在调查 RBBB 对无症状人群中经冠状动脉计算机断层扫描血管造影 (CCTA) 检测到的亚临床冠状动脉粥样硬化的影响。我们回顾性分析了 7205 名无症状个体（平均年龄 54.4 ± 7.9 岁，4695 名男性[65.2%]）的资料，这些个体均无冠心病既往史，他们自愿接受 CCTA 和 12 导联心电图评估作为一般健康检查的一部分。通过 CCTA 评估亚临床冠状动脉粥样硬化的程度和范围，并将≥50%的直径狭窄定义为显著狭窄。通过逻辑回归和倾向评分匹配分析确定 RBBB 与亚临床冠状动脉粥样硬化之间的关联。在研究参与者中，有 116 名（1.6%）患有 RBBB。在校正心血管危险因素后，RBBB 患者发生任何粥样斑块（比值比 0.87，95%置信区间 [CI] 0.57 至 1.32）、钙化斑块（0.78，95%CI 0.51 至 1.19）、非钙化斑块（1.44，95%CI 0.77 至 2.69）、混合斑块（1.12，95%CI 0.52 至 2.39）和显著冠状动脉狭窄（0.92，95%CI 0.48 至 1.74）的校正比值无统计学显著差异。同样，在 5：1 倾向评分匹配人群（n=696）中，RBBB 患者与无 RBBB 患者之间任何亚临床冠状动脉粥样硬化的比值无统计学显著差异（所有 p 值均>0.05）。总之，通过对接受 CCTA 和心电图评估的无症状个体进行这项大型横断面研究，与无 RBBB 患者相比，RBBB 个体的亚临床冠状动脉粥样硬化风险无增加。
