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Updated: Apr 13, 2026

Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
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Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research

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Association Between Complete Right Bundle Branch Block and Vascular Endothelial Function

Aya Mizobuchi1, Tatsuya Maruhashi1, Yusuke Saito1

  • 1Department of Regeneration and Medicine, Division of Radiation Medical Science Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.

JACC. Asia
|April 11, 2026
PubMed

Insights

Complete right bundle branch block (CRBBB) is linked to endothelial dysfunction, indicating it’s not always a benign finding. This suggests CRBBB may signal underlying vascular issues, impacting cardiovascular risk assessment.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Electrocardiography

Background:

  • Complete right bundle branch block (CRBBB) is a common ECG finding, often considered benign.
  • Emerging evidence links CRBBB to arteriosclerosis and increased cardiovascular risk.

Purpose of the Study:

  • To investigate the association between CRBBB and vascular function.
  • To evaluate endothelial and vascular smooth muscle function in individuals with and without CRBBB.

Main Methods:

  • Included 1,308 individuals (55 with CRBBB, 1,253 controls).
  • Assessed endothelial function via flow-mediated vasodilation (FMD).
  • Assessed vascular smooth muscle function via nitroglycerine-induced vasodilation (NID).

Main Results:

  • FMD was significantly lower in the CRBBB group (3.2%) compared to controls (4.6%), P < 0.001.
  • CRBBB was significantly associated with endothelial dysfunction (OR: 1.84; P = 0.047).
  • NID was lower in the CRBBB group (11.5%) vs controls (13.1%), P = 0.024, but no significant association with vascular smooth muscle dysfunction was found (OR: 1.09; P = 0.816).

Conclusions:

  • CRBBB is associated with endothelial dysfunction.
  • These findings suggest CRBBB is not always a benign finding from a vascular function perspective.
  • CRBBB may serve as an indicator for further vascular risk assessment.
Abstract

Keywords:
complete right bundle branch blockflow-mediated vasodilationnitroglycerine-induced vasodilationvascular function

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