The effect of idiopathic premature ventricular complexes on left ventricular ejection fraction
The effect of idiopathic premature ventricular complexes on left ventricular ejection fraction
复制标题
DOI：
10.1111/anec.12702
复制
发表时间：
2020-03-01
影响因子：
1.9
通讯作者：
Tanboga, Ibrahim Halil
中科院分区：
文献类型：
--
作者：
Altintas, Bernas;Ozkalayci, Flora;Tanboga, Ibrahim Halil
目的 目前文献缺乏预测心肌病 (CMP) 的特发性室性早搏 (PVC) 负荷的明确阈值。本研究的主要目的是评估 PVC 负荷与左心室射血分数 (LVEF) 之间的关系。 方法 这项多中心、横断面研究包括 2019 年 1 月至 2019 年 5 月期间在 19 个不同中心的心脏病诊所收治的 341 名连续患者，这些患者在 24 小时动态心电图监测中出现超过 1,000 次特发性 PVC。主要结果是超声心动图检查期间测量的 LVEF。 结果 总体而言，中位年龄为 50 岁（38-60 岁），其中 139 名（49.4%）为女性。 PVC 负荷中位数的百分比为 9%（IQR：4%-17.4%）。中位 LVEF 为 60% (55-65)。我们使用比例优势逻辑回归方法来检查连续 LVEF 与候选预测变量之间的关系。 PVC 负担增加 (%)（回归系数 (RE) -0.644 和 95% CI -1.063、-0.225，p < .001）、PVC QRS 持续时间（RE-0.191 和 95% CI -0.529、0.148，p = .049）和年龄（RE-0.249 和 95% CI -0.442， -0.056，p = .018）与 LVEF 降低相关。当 PVC 负荷高于 5% 时，PVC 负荷与 LVEF 之间的这种反比关系变得更加突出。列线图用于估计 LVEF 降低的个体风险。结论 我们的研究表明，PVC 负荷百分比、年龄和 PVC QRS 持续时间的增加与特发性 PVC 患者的 LVEF 降低独立相关。此外，在 PVC 负荷低于之前已知的情况下，观察到 PVC 负荷与 LVEF 之间呈反比关系。
Aim Current literature lacks a definitive threshold of idiopathic premature ventricular complex (PVC) burden for predicting cardiomyopathy (CMP). The main objective of the present study was to evaluate relationship between the PVC burden and left ventricular ejection fraction (LVEF).Method This multicenter, cross-sectional study included 341 consecutive patients with more than 1,000 idiopathic PVC in 24 hr of Holter monitoring admitted to the cardiology clinics between January 2019 and May 2019 in the nineteen different centers. The primary outcome was the LVEF measured during the echocardiographic examination.Result Overall, the median age was 50 (38-60) and 139 (49.4%) were female. Percentage of median PVC burden was 9% (IQR: 4%-17.4%). Median LVEF was found 60% (55-65). We used proportional odds logistic regression method to examine the relationship between continuous LVEF and candidate predictors. Increase in PVC burden (%) (regression coefficient (RE) -0.644 and 95% CI -1.063, -0.225, p < .001), PVC QRS duration (RE-0.191 and 95% CI -0.529, 0.148, p = .049), and age (RE-0.249 and 95% CI -0.442, -0.056, p = .018) were associated with decrease in LVEF. This inverse relationship between the PVC burden and LVEF become more prominent when PVC burden was above 5%. A nomogram developed to estimate the individual risk for decrease in LVEF.Conclusion Our study showed that increase in PVC burden %, age, and PVC QRS duration were independently associated with decrease in LVEF in patients with idiopathic PVC. Also, inverse relationship between PVC burden and LVEF was observed in lower PVC burden than previously known.