Title: Is RBBB More Indicative of Large Anteroseptal MI?
题目：右束支传导阻滞更能反映大面积前间壁心肌梗死吗？
Author 作者: Semhar Tewelde
 
Conventionally a new onset left bundle branch (LBBB) with acute myocardial infarction (MI) is associated with a massive MI
传统概念上一个新发生的左束支传导阻滞（ LBBB ）是与一个大面积心肌梗死（ MI ）有关。
Proximal left anterior descending artery (LAD) septal perforators perfuse the right bundle branch and the anterior fascicle of the left bundle branch ~90% of cases
90％的病例中，近端左前降支（ LAD ） 的室间隔支灌注右束支和左束支 的前分支。
The right coronary artery (RCA) perfuses the posterior fascicle of the left bundle branch ~90% of cases
90％的病例中，右冠状动脉（ RCA ）灌注左束支的后分支。
Given the anatomy, a LAD occlusion should cause RBBB and/or LAFB; both a proximal LAD and RCA occlusion would be required for MI to cause LBBB
从解剖意义上讲， LAD闭塞将导致右束支传导阻滞和/或左前降支（LAFB）阻滞；要造成左束支传导阻滞需要近端LAD和RCA都闭塞。
A recent cohort study analyzed 233 patients to evaluate if RBBB or LBBB was associated with a large anteroseptal scar:
最近的一个队列研究对233例患者进行分析，以证明是右束支传导阻滞还是左束支传导阻滞与一个大面积前间壁疤痕有关：
RBBB was associated with larger scar size (24% vs. 6.5%; p<0.0001)
右束支传导阻滞与较大的疤痕相关（ 24％对6.5％ ， P < 0.0001 ）
RBBB was more indicative of ischemic heart disease (79% vs. 29%; p<0.0001)
右束支传导阻滞在预测缺血性心脏疾病时更有意义（ 79 ％对29％ ， P < 0.0001 ）
Based on this preliminary data RBBB may have a stronger association with ischemia and anteroseptal scarring than LBBB (*limitations - small cohort of cardiomyopathy patients with an EF<35%, further study is required)
基于这一前期数据，RBBB与前间壁缺血和疤痕的关系要比左束支传导阻滞强（ *局限性 -心肌病患者伴EF < 35 ％的小队列研究，需要进一步证实）。

References 参考文献：
Strauss DG, Loring Z, Selvester RH, et al. Right, But Not Left, Bundle Branch Block Is Associated With Large Anteroseptal Scar. JACC. Sept 2013; 62(11): 959-967.