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首页> 外文期刊>ESC Heart Failure >Lower than expected burden of premature ventricular contractions impairs myocardial function
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Lower than expected burden of premature ventricular contractions impairs myocardial function

机译：早于心室收缩的负担低于预期会损害心肌功能

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Abstract Aims We aimed to explore the burden of frequent premature ventricular contractions (PVCs) associated with myocardial dysfunction in patients with outflow tract arrhythmia (OTA). We hypothesized that this threshold is lower than the previously suggested threshold of 24 000 PVCs/24 h (24%PVC) when systolic function is assessed by strain echocardiography. Furthermore, we aimed to characterize OTA patients with malignant arrhythmic events. Methods and results We included 52 patients referred for OTA ablation (46 ???± 12 years, 58% female). Left ventricular global longitudinal strain (GLS) and mechanical dispersion were assessed by speckle tracking echocardiography. A subset underwent cardiac magnetic resonance imaging. PVC burden (%PVC) was assessed by Holter recording. Sinus rhythm QRS duration and PVC QRS duration were recorded from electrocardiogram, and the ratio was calculated (PVC QRS duration / sinus rhythm QRS duration). Median %PVC was 7.2 (0.2?￠????60.0%). %PVC correlated with GLS (R = 0.44, P = 0.002) and with mechanical dispersion (R = 0.48, P < 0.001), but not with ejection fraction (R = 0.22, P = 0.12). %PVC was higher in patients with impaired systolic function by GLS (worse than ?￠????18%) compared with patients with normal function (22% vs. 5%, P = 0.001). Greater than 8%PVC optimally identified patients with abnormal GLS (area under the curve 0.79). Serious arrhythmic events occurred in 11/52 (21%) patients characterized by high QRS ratios (1.56 vs. 1.91, P < 0.001). Conclusions More than 8%PVC was associated with impaired systolic function by GLS, which is a lower threshold than previously reported. Patients with serious arrhythmic events had higher QRS ratios, which may represent a more malignant phenotype of OTA.
机译：摘要目的我们旨在探讨流出道心律失常（OTA）患者频繁发生的室性早搏（PVC）与心肌功能障碍相关的负担。我们假设当通过应变超声心动图评估收缩功能时，该阈值低于先前建议的24000 PVCs / 24 h（24％PVC）阈值。此外，我们旨在表征具有恶性心律失常事件的OTA患者。方法和结果我们纳入了52例接受OTA消融的患者（46±12岁，女性58％）。通过散斑跟踪超声心动图评估左心室总纵向应变（GLS）和机械分散。一个子集进行了心脏磁共振成像。通过Holter记录评估PVC负荷（％PVC）。从心电图记录窦性心律QRS持续时间和PVC QRS持续时间，并计算比率（PVC QRS持续时间/窦性心律QRS持续时间）。 PVC的中位数％是7.2（0.2％≤60.0％）。 ％PVC与GLS（R ＝ 0.44，P ＝ 0.002）和机械分散性（R ＝ 0.48，P ＜0.001）相关，但与射血分数无关（R ＝ 0.22，P ＝ 0.12）。与功能正常的患者相比，GLS的收缩功能受损的患者中的PVC值更高（差于18％）（22％vs. 5％，P = 0.001）。大于8％的PVC可以最佳地识别出GLS异常的患者（曲线下面积0.79）。 11/52（21％）患者发生严重的心律不齐事件，其QRS比率高（1.56比1.91，P <0.001）。结论超过8％的PVC与GLS的收缩功能受损有关，该阈值低于先前报道。严重心律失常事件的患者QRS比率较高，这可能代表了OTA的恶性表型。

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