Schneider J F, Thomas H E, Kreger B E, McNamara P M, Sorlie P, Kannel W B
Ann Intern Med. 1980 Jan;92(1):37-44. doi: 10.7326/0003-4819-92-1-37.
Cardiovascular abnormalities were identified prospectively in all 70 persons who developed complete right bundle-branch block (RBBB) in The Framingham Study during 18 years of biennial follow-up. Most were hypertensive before the appearance of RBBB. Although the initial appearance of RBBB was usually unaccompanied by overt clinical events, the subsequent incidence of coronary disease and congestive failure was two and one-half and four times greater, respectively, than that in matched control subjects without RBBB. The incidence of cardiovascular disease mortality was almost three times greater in persons who developed RBBB than in an age-matched sample of the population-at-large. This excess of cardiovascular disease mortality was related primarily to the high prevalence of associated cardiovascular abnormalities. Only 21% remained free from clinically apparent cardiovascular abnormalities. A QRS duration of greater than or equal to 130 ms and a QRS axis between -45 degrees and -90 degrees identified those most likely to have associated cardiovascular abnormalities.
在弗雷明汉心脏研究中，对70例在18年的每两年一次随访期间发生完全性右束支传导阻滞（RBBB）的患者进行了前瞻性心血管异常鉴定。大多数患者在出现RBBB之前就患有高血压。虽然RBBB的初次出现通常不伴有明显的临床事件，但随后冠心病和充血性心力衰竭的发生率分别是无RBBB的匹配对照受试者的2.5倍和4倍。发生RBBB的患者心血管疾病死亡率几乎是年龄匹配的总体人群样本的3倍。这种心血管疾病死亡率的增加主要与相关心血管异常的高患病率有关。只有21%的患者没有明显的心血管异常。QRS时限大于或等于130毫秒以及QRS电轴在-45度至-90度之间可确定那些最有可能伴有心血管异常的患者。
