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- Title
Frequent Premature Ventricular Complex Is Associated with Left Atrial Enlargement in Patients with Normal Left Ventricular Ejection Fraction.
- Authors
PARK, YEONJEONG; KIM, SUJI; SHIN, JEWOOK; OH, AH REUM; SHIN, EUN JI; LEE, JUNG HOON; AHN, TAEHOON; CHA, JI‐YOUNG; MOON, JEONGGEUN
- Abstract
Background Premature ventricular complex (PVC) has been regarded as benign; however, when frequent, the arrhythmia can induce left ventricular (LV) systolic dysfunction. Meanwhile, the influence of PVCs on cardiac structural remodeling and functional change before occurrence of overt systolic heart failure has not been fully described. In this study, we attempted to identify early cardiac structural/functional manifestations of frequent PVCs in patients with normal LV systolic function. Methods A total of 146 patients (age: 55 ± 15 years, 48 males) with frequent PVCs observed on 24-hour Holter monitoring (>10/h) and normal LV ejection fraction (LV EF ≥ 55% on echocardiography) were enrolled. Clinical characteristics and echocardiographic parameters of the patients were compared with those of an age-/sex-matched control group (n = 292, age: 55 ± 15 years, 96 males). Results Patients with frequent PVCs had significantly larger left atrial volume index (LAVI [28 ± 9 mL/m2 vs. 24 ± 7 mL/m2]), along with larger LV end-diastolic dimension (49.4 ± 4.4 mm vs. 48.5 ± 3.9 mm), lower LV EF (63 ± 7% vs. 66 ± 6%), and lower peak systolic mitral annular velocity (7 ± 2 cm/s vs. 8 ± 2 cm/s; P < 0.05 for all), whereas other clinical characteristics were similar. In particular, in patients with frequent PVCs, LAVI showed linear correlation with PVC burden (R = 0.30, P < 0.001), and, in a multiple regression model, PVC burden independently estimated LAVI, even after controlling for age, sex, comorbidities, and systolic function (β = 0.309, P < 0.001). Conclusion Frequent PVC is associated with LA enlargement in patients with normal LV EF. Atrial anatomical remodeling may precede LV geometry change and systolic dysfunction in patients with frequent PVCs.
- Subjects
LEFT heart ventricle; HEART ventricle diseases; ARRHYTHMIA; CHI-squared test; CONFIDENCE intervals; STATISTICAL correlation; RESEARCH funding; STATISTICS; T-test (Statistics); DATA analysis; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio; MANN Whitney U Test; DISEASE complications; DISEASE risk factors
- Publication
Pacing & Clinical Electrophysiology, 2014, Vol 37, Issue 11, p1455
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.12447