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Xu W, Li M, Chen M, Yang B, Wang D, Kong X, Chen H, Ju W, Gu K, Cao K, Liu H, Jiang Q, Shi J, Cui Y, Wang H. Effect of burden and origin sites of premature ventricular contractions on left ventricular function by 7-day Holter monitor. J Biomed Res 2015; 29:465-74. [PMID: 26668581 PMCID: PMC4662208 DOI: 10.7555/jbr.29.20150032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 04/10/2015] [Accepted: 06/10/2015] [Indexed: 11/10/2022] Open
Abstract
Recent studies have shown that premature ventricular contractions (PVCs) could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due to day-to-day variability. Our purpose was to investigate the effect of burden and origin sites on left ventricular (LV) function in patients with PVCs by 7-day Holter electrocardiography (ECG). From May 2012 to August 2013, 112 consecutive patients with PVCs were recruited from the authors' affiliated hospital. All patients received 2-dimensional transthoracic echocardiography, 12-lead routing ECG and 7-days Holter ECG. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured. A total of 102 participants with PVCs were included in the final analysis. Origin of PVCs from the tricuspid annulus had the highest burden and NT-proBNP level. LV papillary muscle had a higher LV ejection fraction (EF) level and a lower LV end-systolic dimension (ESD) than other PVC foci (P<0.05). The high burden group had a higher LV end-diastolic dimension (EDD) and LVESD but lower LVEF than the other two groups (P<0.05). Female, older age, physical work, and history of PVCs had a significantly positive correlation with symptoms. Male, older age, physical work, and high burden were positive predictors of enlarged LVEDD, LVESD and higher serum NT-proBNP level, but lower LVEF. Seven-day dynamic ECG Holter monitor showed the true PVC burden on patients with PVCs. PVCs with a lower burden or origin from the LV papillary muscle and the fascicle were relatively benign, while PVCs with a higher burden or origin from the tricuspid annulus may lead to cardiac dysfunction.
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Affiliation(s)
- Wenhua Xu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Mingfang Li
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Minglong Chen
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Bing Yang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Daowu Wang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Xiangqing Kong
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Hongwu Chen
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Weizhu Ju
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Kai Gu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Kejiang Cao
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Hailei Liu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Qi Jiang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Jiaojiao Shi
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Yan Cui
- Nursing College of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Hong Wang
- Department of Respiratory, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
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Blaauw Y, Pison L, van Opstal J, Dennert R, Heesen W, Crijns H. Reversal of ventricular premature beat induced cardiomyopathy by radiofrequency catheter ablation. Neth Heart J 2010; 18:493-8. [PMID: 20978594 PMCID: PMC2954302 DOI: 10.1007/bf03091821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Frequent monomorphic ventricular premature beats (VPBs) may lead to left ventricular dysfunction. We describe two patients with frequent monomorphic VPBs and dilated cardiomyopathy in whom left ventricular function normalised after elimination of the VPBs by radiofrequency catheter ablation. The recent literature on this topic is summarised and potential candidates for catheter ablation are discussed. (Neth Heart J 2010;18:493-8.).
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Affiliation(s)
- Y. Blaauw
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - L. Pison
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - J.M. van Opstal
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - R.M. Dennert
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - W.F. Heesen
- Department of Cardiology, VieCuri Medical Center, Venlo, the Netherlands
| | - H.J.G.M. Crijns
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
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