Right bundle branch block: prevalence, risk factors, and outcome in the general population: results from the Copenhagen City Heart Study
Right bundle branch block: prevalence, risk factors, and outcome in the general population: results from the Copenhagen City Heart Study
复制标题
DOI：
10.1093/eurheartj/ehs291
复制
发表时间：
2013-01-01
影响因子：
39.3
通讯作者：
Prescott, Eva
中科院分区：
文献类型：
--
作者：
Bussink, Barbara E.;Holst, Anders G.;Prescott, Eva
为了确定一般人群中男性和女性静息 12 导联心电图上右束支传导阻滞 (RBBB) 和不完全性 RBBB (IRBBB) 的患病率、新发性预测因素和预后价值。我们通过注册链接对 19762003 年检查的哥本哈根城市心脏研究中的 18 441 名参与者进行了跟踪，其中没有既往心肌梗塞 (MI)、慢性心力衰竭和左束支传导阻滞，直到2009 年全因死亡率和心血管结局。男性 RBBB/IRBBB 患病率较高（男性 1.4/4.7，女性 0.5/2.3，P < 0.001）。新获得 RBBB 的显着预测因素是男性、年龄增加、高收缩压和 IRBBB 的存在，而新获得 IRBBB 的预测因素是男性、年龄增加和低 BMI。右束支传导阻滞与男女全因死亡率和心血管死亡率显着增加相关，性别汇总分析中年龄调整后的风险比 (HR) 分别为 1.31 [95 CI, 1.111.54] 和 1.87 (95 CI, 1.482.36)，多重调整后几乎没有衰减。右束支传导阻滞与心肌梗死风险增加相关，HR 为 1.67 (95 CI, 1.162.42)，与起搏器植入风险增加相关，HR 为 2.17 (95 CI, 1.223.86)，但与慢性心力衰竭 (HR 1.37; 95 CI, 0.961.94)、心房颤动 (HR 1.10; 95 CI, 1.223.86) 无关。 0.731.67），或慢性阻塞性肺疾病（HR 0.99；95 CI，0.601.62）。 IRBBB 的存在与任何不良后果无关。在这项队列研究中，男性中 RBBB 和 IRBBB 的发生率是女性的两到三倍。右束支传导阻滞与心血管风险和全因死亡率增加相关，而 IRBBB 则不然。与普遍看法相反，无症状个体的 RBBB 应提醒临床医生注意心血管风险。
To determine the prevalence, predictors of newly acquired, and the prognostic value of right bundle branch block (RBBB) and incomplete RBBB (IRBBB) on a resting 12-lead electrocardiogram in men and women from the general population.We followed 18 441 participants included in the Copenhagen City Heart Study examined in 19762003 free from previous myocardial infarction (MI), chronic heart failure, and left bundle branch block through registry linkage until 2009 for all-cause mortality and cardiovascular outcomes. The prevalence of RBBB/IRBBB was higher in men (1.4/4.7 in men vs. 0.5/2.3 in women, P 0.001). Significant predictors of newly acquired RBBB were male gender, increasing age, high systolic blood pressure, and presence of IRBBB, whereas predictors of newly acquired IRBBB were male gender, increasing age, and low BMI. Right bundle branch block was associated with significantly increased all-cause and cardiovascular mortality in both genders with age-adjusted hazard ratios (HR) of 1.31 [95 confidence interval (CI), 1.111.54] and 1.87 (95 CI, 1.482.36) in the gender pooled analysis with little attenuation after multiple adjustment. Right bundle branch block was associated with increased risk of MI with an HR of 1.67 (95 CI, 1.162.42) and pacemaker insertion with an HR of 2.17 (95 CI, 1.223.86), but not with chronic heart failure (HR 1.37; 95 CI, 0.961.94), atrial fibrillation (HR 1.10; 95 CI, 0.731.67), or chronic obstructive pulmonary disease (HR 0.99; 95 CI, 0.601.62). The presence of IRBBB was not associated with any adverse outcome.In this cohort study, RBBB and IRBBB were two to three times more common among men than women. Right bundle branch block was associated with increased cardiovascular risk and all-cause mortality, whereas IRBBB was not. Contrary to common perception, RBBB in asymptomatic individuals should alert clinicians to cardiovascular risk.