Tachycardia-Induced Cardiomyopathy in Patients With Idiopathic Ventricular Arrhythmias: The Incidence, Clinical and Electrophysiologic Characteristics, and the Predictors
Tachycardia-Induced Cardiomyopathy in Patients With Idiopathic Ventricular Arrhythmias: The Incidence, Clinical and Electrophysiologic Characteristics, and the Predictors
复制标题
DOI：
10.1111/j.1540-8167.2010.01986.x
复制
发表时间：
2011-06-01
影响因子：
2.7
通讯作者：
Can, Levent H.
中科院分区：
文献类型：
--
作者：
Hasdemir, Can;Ulucan, Cem;Can, Levent H.
特发性室性心律失常与心肌病。简介：单形性室性早搏（PVC）和/或室性心动过速（VT）形式的特发性室性心律失常可导致心动过速诱导的心肌病（TICMP）。本研究的目的是确定发病率，临床和电生理特征，TICMP的预测因素在特发性室性心律失常患者。方法：研究人群包括249例连续患者（148 F/101 M，45 +/- 20 y/o）频繁PVC和/或VT。所有患者均接受经胸超声心动图和24小时霍尔特监测。TICMP定义为有效治疗指数室性心律失常后左室射血分数（LVEF）≥ 15%。与LVEF保留的患者相比，TICMP患者更可能是男性（65% vs 39%，P = 0.043）和无症状（29% vs 9%，P = 0.018），并且更可能具有较高的PVC负荷（29.4 ± 9.2 vs 8.1 ± 7.4，P < 0.001），全天持续性PVC（65% vs 22%，P = 0.001）和重复性单形性VT（24% vs 0.9%，P < 0.001）。通过ROC曲线分析，16%的PVC负荷最好地将TICMP患者与LVEF保留的患者分开（敏感性100%，特异性87%，曲线下面积0.96）。结论：TICMP在我们的研究人群中相对常见（类似于每15例患者中有1例）。TICMP的预测因素为男性、无症状、PVC负荷≥ 16%、全天持续性PVC和存在重复性单形性VT。（J.E. Vasc Electrophysiol，Vol. 22，pp. 663-668，2011年6月）
Idiopathic Ventricular Arrhythmias and Cardiomyopathy. Introduction: Idiopathic ventricular arrhythmias in the form of monomorphic premature ventricular contractions (PVC) and/or ventricular tachycardia (VT) can cause tachycardia-induced cardiomyopathy (TICMP). The aim of this study was to determine the incidence, clinical and electrophysiologic characteristics, and the predictors of TICMP in patients with idiopathic ventricular arrhythmias.Methods: Study population consisted of 249 consecutive patients (148 F/101 M, 45 +/- 20 y/o) with frequent PVCs and/or VT. All patients underwent transthoracic echocardiography and 24-hour Holter monitoring. TICMP was defined as left ventricular ejection fraction (LVEF) of = 15% following effective treatment of index ventricular arrhythmia.Results: Seventeen (6.8%) patients had TICMP. Patients with TICMP compared to patients with preserved LVEF were more likely to be male (65% vs 39%, P = 0.043) and asymptomatic (29% vs 9%, P = 0.018), and were more likely to have higher PVC burden (29.4 +/- 9.2 vs 8.1 +/- 7.4, P < 0.001), persistence of PVCs throughout the day (65% vs 22%, P = 0.001), and repetitive monomorphic VT (24% vs 0.9%, P < 0.001). PVC burden of 16% by ROC curve analysis best separated the patients with TICMP compared to patients with preserved LVEF (sensitivity 100%, specificity 87%, area under curve 0.96).Conclusions: TICMP was relatively common (similar to 1 in every 15 patients) in our study population. The predictors of TICMP were male gender, absence of symptoms, PVC burden of >= 16%, persistence of PVCs throughout the day, and the presence of repetitive monomorphic VT. (J Cardiovasc Electrophysiol, Vol. 22, pp. 663-668, June 2011)