Effect of burden and origin sites of premature ventricular contractions on left ventricular function by 7-day Holter monitor

作     者：Wenhua Xu Mingfang Li Minglong Chen Bing Yang Daowu Wang Xiangqing Kong Hongwu Chen Weizhu Ju Kai Gu Kejiang Cao Hailei Liu Qi Jiang Jiaojiao Shi Yan Cui Hong Wang 

作者机构：Department of Cardiologythe First Affiliated Hospital of Nanjing Medical University Nursing College of Nanjing Medical University Department of Respiratorythe First Affiliated Hospital of Nanjing Medical University 

出 版 物：《The Journal of Biomedical Research》 (生物医学研究杂志（英文版）)

年 卷 期：2015年第29卷第6期

页      面：465-474页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：supported by the innovation project in Jiangsu province,China the Program for Development of Innovative Research Team in the First Affiliated Hospital of NJMU(IRT-004) 

主　　题：premature ventricular contractions burden origin sites left ventricular function 

摘      要：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.