The effect of idiopathic premature ventricular complexes on left ventricular ejection fraction

• Published in: Annals of noninvasive electrocardiology Vol. 25; no. 2; pp. e12702 - n/a
• Main Authors: Altıntaş, Bernas, Özkalaycı, Flora, Çinier, Göksel, Kaya, İlyas, Aktan, Adem, Küp, Ayhan, Onuk, Raşit, Özcan, Sevgi, Uslu, Abdulkadir, Akyüz, Abdurrahman, Atıcı, Adem, Ekinci, Selim, Akın, Halil, Yılmaz, Mehmet Fatih, Koç, Şahbender, Tanık, Veysel Ozan, Harbalıoğlu, Hazar, Barman, Hasan Ali, Afşin, Abdülmecit, Gümüşdağ, Ayça, Alibaşiç, Hayrudin, Karabağ, Yavuz, Cap, Murat, Baysal, Erkan, Tanboğa, İbrahim Halil
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01-03-2020; John Wiley and Sons Inc
• Subjects: Adult; Age; Cardiology; Cardiomyopathy; Cross-Sectional Studies; Echocardiography; Ejection fraction; Electrocardiography, Ambulatory; Female; Heart; Humans; left ventricular ejection fraction; Male; Middle Aged; Nomograms; Original; premature ventricular complexes; Regression coefficients; Stroke Volume; Ventricle; Ventricular Dysfunction, Left - physiopathology; Ventricular Premature Complexes - physiopathology; premature ventricular complexes; cardiomyopathy; left ventricular ejection fraction
• ISSN: 1082-720X; 1542-474X
• DOI: 10.1111/anec.12702

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.