Fleg J L, Das D N, Lakatta E G
J Am Coll Cardiol. 1983 Mar;1(3):887-92. doi: 10.1016/s0735-1097(83)80204-6.
The long-term cardiac prognosis of 24 clinically healthy men with complete right bundle branch block, identified from the 1,142 men constituting the population of the Baltimore Longitudinal Study on Aging, was assessed over a follow-up period averaging 8.4 years. When compared with a control group matched for age at which right bundle branch block appeared (mean +/- standard deviation 64.0 +/- 13.5 years), men with right bundle branch block showed no difference in the prevalence of antecedent coronary risk factors or obstructive lung disease. The incidence of angina pectoris, myocardial infarction, valvular heart disease, cardiomegaly, congestive heart failure, advanced heart block or cardiac death in these men did not differ from that of the control group over the observation period. Furthermore, at the latest follow-up study, maximal aerobic exercise tolerance and chronotropic response to maximal exercise were not impaired in men with right bundle branch block relative to control men (9.1 +/- 2.2 versus 7.3 +/- 3.0 minutes and 150.3 +/- 23.5 versus 147.7 +/- 20.7 beats/minute, respectively). However, axis deviation leftward of -30 degrees was present in 46% of men with right bundle branch block but in only 15% of control subjects at latest follow-up (probability [p] less than 0.01). Although the PR interval lengthened by 40 ms or more developed in only 6% of control subjects over the observation period, such prolongation occurred in 29% of men with right bundle branch block (p less than 0.05). These results support the concept that right bundle branch block in these asymptomatic men is a manifestation of a primary abnormality of the cardiac conduction system but has no demonstrable adverse effect on long-term cardiac morbidity or mortality.
从参与巴尔的摩纵向衰老研究的1142名男性中识别出24名临床健康且患有完全性右束支传导阻滞的男性，对其进行了平均8.4年的随访，以评估其长期心脏预后。与在出现右束支传导阻滞时年龄匹配的对照组（平均±标准差为64.0±13.5岁）相比，患有右束支传导阻滞的男性在既往冠心病危险因素或阻塞性肺病的患病率上没有差异。在观察期内，这些男性的心绞痛、心肌梗死、瓣膜性心脏病、心脏扩大、充血性心力衰竭、高度房室传导阻滞或心源性死亡的发生率与对照组没有差异。此外，在最近的随访研究中，相对于对照组男性，患有右束支传导阻滞的男性的最大有氧运动耐量和对最大运动的变时反应并未受损（分别为9.1±2.2分钟对7.3±3.0分钟，以及150.3±23.5次/分钟对147.7±20.7次/分钟）。然而，在最近一次随访时，46%的右束支传导阻滞男性出现了-30度或更大的电轴左偏，而对照组中只有15%出现这种情况（概率[p]<0.01）。尽管在观察期内只有6%的对照组受试者出现PR间期延长40毫秒或更多，但29%的右束支传导阻滞男性出现了这种延长（p<0.05）。这些结果支持了这样一种观点，即这些无症状男性的右束支传导阻滞是心脏传导系统原发性异常的一种表现，但对长期心脏发病率或死亡率没有明显的不良影响。
