Sun Yiping, Blom Nico A, Yu Yonghui, Ma Peiran, Wang Yi, Han Xiuzhen, Swenne Cees A, van der Wall Ernst E
Shandong Provincial Hospital, Jinan 250021, PR China.
Int J Cardiovasc Imaging. 2003 Aug;19(4):295-9. doi: 10.1023/a:1025418531853.
Isolated monomorphic premature ventricular contractions (PVCs) are not uncommon in the pediatric population. The degree of cardiac dysfunction caused by PVCs in children without structural heart disease is unknown.
To investigate the influence of PVCs on echocardiographic left ventricular (LV) systolic function in children without structural heart disease.
Forty asymptomatic children with isolated monomorphic PVCs without structural heart disease were selected. The median age was 6 years, range of 3-12 years. The following subgroups were compared: frequent vs. infrequent PVCs (> or < or = 10/min); short vs. long coupling interval (RR'/RR ratio < or = or > 0.6); and short vs. long QT interval (QT < or = or > 400 ms). Using echocardiography the left ventricular ejection fraction (LVEF in percentage) and cardiac index (CI in L/min/m2) were measured for both normal sinus beats (SB-LVEF and CI), PVCs (PVC-LVEF and CI) and the average LVEF and CI were calculated. All values were expressed as means +/- SD.
In all children LV dimensions and the SB-LVEF and CI were within normal limits. The PVC-LVEF (48 +/- 5) and PVC-CI (1.57 +/- 0.19) were significantly decreased and the average CI was 2.41 +/- 0.29. In 27 pts with > 10 PVCs/min the average LVEF and CI decreased to 53 +/- 5 and 2.08 +/- 0.24 respectively. In 16 pts with PVCs and a short coupling interval (RR'/RR < or = 0.6) the PVC-LVEF and PVC-CI was 43 +/- 0.03 and 1.50 +/- 0.14, which was significantly lower than in 24 pts with a long coupling interval (58 +/- 4, 1.88 +/- 0.11). In 11 pts with a prolonged QT interval (> 400 ms) the PVC-LVEF and PVC-CI was significantly lower than in the 29 children with a shorter QT interval, 41 +/- 5 vs. 55 +/- 4 and 1.46 +/- 0.13 vs. 1.86 +/- 0.15 respectively (all p < 0.01).
In asymptomatic children with isolated monomorphic PVCs the average ejection fraction and cardiac output is markedly reduced if PVCs are frequent (> 10/min), have a short coupling interval or a prolonged QT interval.
孤立性单形性室性早搏（PVCs）在儿科人群中并不少见。无结构性心脏病的儿童中，PVCs所致心脏功能障碍的程度尚不清楚。
研究PVCs对无结构性心脏病儿童超声心动图左心室（LV）收缩功能的影响。
选取40例无结构性心脏病的无症状孤立性单形性PVCs儿童。中位年龄6岁，范围3 - 12岁。比较以下亚组：频发与偶发PVCs（>或<或=10次/分钟）；短与长联律间期（RR'/RR比值<或=或>0.6）；短与长QT间期（QT<或=或>400毫秒）。使用超声心动图测量正常窦性心律时的左心室射血分数（LVEF，以百分比表示）和心脏指数（CI，以L/分钟/平方米表示）、PVCs时的（PVC - LVEF和CI），并计算平均LVEF和CI。所有值均表示为均值±标准差。
所有儿童的左心室大小、窦性心律时的LVEF和CI均在正常范围内。PVCs时的LVEF（48±5）和PVCs时的CI（1.57±0.19）显著降低，平均CI为2.41±0.29。在27例PVCs>10次/分钟的患儿中，平均LVEF和CI分别降至53±5和2.08±0.24。在16例PVCs且联律间期短（RR'/RR<或=0.6）的患儿中，PVCs时的LVEF和PVCs时的CI为43±0.03和1.50±0.14，显著低于24例联律间期长的患儿（58±4，1.88±0.11）。在11例QT间期延长（>400毫秒）的患儿中，PVCs时的LVEF和PVCs时的CI显著低于29例QT间期短的儿童，分别为41±5对55±4和1.46±0.13对1.86±0.15（均p<0.01）。
在无症状的孤立性单形性PVCs儿童中，如果PVCs频发（>10次/分钟）、联律间期短或QT间期延长，平均射血分数和心输出量会显著降低。
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