Relationship between burden of premature ventricular complexes and left ventricular function.
| Autor: | Baman TS; Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA., Lange DC, Ilg KJ, Gupta SK, Liu TY, Alguire C, Armstrong W, Good E, Chugh A, Jongnarangsin K, Pelosi F Jr, Crawford T, Ebinger M, Oral H, Morady F, Bogun F |
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| Jazyk: | angličtina |
| Zdroj: | Heart rhythm [Heart Rhythm] 2010 Jul; Vol. 7 (7), pp. 865-9. Date of Electronic Publication: 2010 Mar 27. |
| DOI: | 10.1016/j.hrthm.2010.03.036 |
| Abstrakt: | Background: Frequent idiopathic premature ventricular complexes (PVCs) can result in a reversible form of left ventricular dysfunction. The factors resulting in impaired left ventricular function are unclear. Whether a critical burden of PVCs can result in cardiomyopathy has not been determined. Objective: The objective of this study was to determine a cutoff PVC burden that can result in PVC-induced cardiomyopathy. Methods: In a consecutive group of 174 patients referred for ablation of frequent idiopathic PVCs, the PVC burden was determined by 24-hour Holter monitoring, and transthoracic echocardiograms were used to assess left ventricular function. Receiver-operator characteristic curves were constructed based on the PVC burden and on the presence or absence of reversible left ventricular dysfunction to determine a cutoff PVC burden that is associated with left ventricular dysfunction. Results: A reduced left ventricular ejection fraction (mean 0.37 +/- 0.10) was present in 57 of 174 patients (33%). Patients with a decreased ejection fraction had a mean PVC burden of 33% +/- 13% as compared with those with normal left ventricular function 13% +/- 12% (P <.0001). A PVC burden of >24% best separated the patient population with impaired as compared with preserved left ventricular function (sensitivity 79%, specificity 78%, area under curve 0.89) The lowest PVC burden resulting in a reversible cardiomyopathy was 10%. In multivariate analysis, PVC burden (hazard ratio 1.12, 95% confidence interval 1.08 to 1.16; P <.01) was independently associated with PVC-induced cardiomyopathy. Conclusion: A PVC burden of >24% was independently associated with PVC-induced cardiomyopathy. (Copyright 2010 Heart Rhythm Society. All rights reserved.) |
| Databáze: | MEDLINE |
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