Premature ventricular contraction-induced cardiomyopathy entails more than only systolic left ventricular dysfunction

Impaired left ventricular global longitudinal strain improves with radiofrequency catheter ablation in patients with PVC-induced cardiomyopathy

BACKGROUND

In our study, we aimed to evaluate left ventricular global longitudinal strain (LV-GLS) value in patients with premature ventricular contractions (PVCs) and reduced LV ejection fraction (LVEF) and to determine the effect of radiofrequency catheter ablation (RFA) procedure on LV-GLS.

METHODS

In this cross-sectional study, 150 patients who underwent three-dimensional RFA with the diagnosis of PVCs were included. LV-GLS was measured with strain echocardiography in all patients before RFA and in the sixth-month control. Patients included in the study were grouped as LVEF <50% (Group I) and LVEF ≥50% (Group II) according to baseline LVEF, and patients within Group I were grouped as LVEF <50% (Group A) and LVEF ≥50% (Group B) according to the sixth-month LVEF.

RESULTS

There were 39 patients (26%) with baseline LVEF <50%. In 14 (36%) of these patients, LVEF <50% was observed to continue during the sixth-month controls. Both the baseline and sixth-month LV-GLS values were significantly lower in Group I patients (<0.01). RFA treatment significantly increased both LVEF and LV-GLS (<0.01). It was found that age, N-terminal pro-brain natriuretic peptide, LV diameters, and baseline LVEF were higher, and baseline LV-GLS level was lower in Group A patients (P < .01). Baseline LVEF and LV-GLS values were found to independently determine the patients in Group A (P < .01). In receiver operator characteristic analysis, when the limit value is accepted as 40% for baseline LVEF and 18% for baseline LV-GLS, it can determine Group A with acceptable sensitivity and specificity.

CONCLUSIONS

LV-GLS decreases significantly in patients with reduced LVEF and PVCs. In these patients, RFA treatment significantly increases both LVEF and LV-GLS.