Chen Ju-Yi, Tsai Wei-Chuan, Lee Yung-Ling, Lee Cheng-Han, Tsai Liang-Miin, Chao Ting-Hsing, Li Yi-Heng, Chen Jyh-Hong, Lin Li-Jen
Division of Cardiology, Department of Internal Medicine, National Cheng Kung University, Hospital, Tainan, Taiwan.
Am Heart J. 2008 Mar;155(3):500.e1-6. doi: 10.1016/j.ahj.2007.11.033. Epub 2008 Jan 18.
Although premature ventricular complex (PVC) occurs frequently, its predisposing factors have rarely been studied. We examined the connection between PVC and aortic stiffness.
We recruited 200 consecutive patients (< 50 years, 95 men, mean age 36 +/- 10 years) who received a 24-hour ambulatory electrocardiography examination for palpitation and PVC loads. Muscular artery pulse wave velocity (PWVm) and 4 main aortic pressure indices-augmented pressure, augmentation index (AI(x)), AI(x) corrected for a steady heart rate of 75 beat/min, and the extra workload-were measured, and atherosclerosis risk was evaluated.
Eighty-three (42%) patients had no PVC loads; 58 (29%) patients had low loads (< 24 beat/d), and 59 (29%) had high loads (> or = 24 beat/d). Only age and hyperlipidemia were significantly associated with PVC loads. Using a multivariate logistic regression model adjusted for potential confounders, we found that AI(x) (odds ratio [OR] 1.88, 95% CI 1.20-2.91, P = .005); augmented pressure (OR 1.57, 95% CI 1.02-2.43, P = .042); AI(x) corrected for a steady heart rate of 75 beat/min (OR 1.82, 95% CI 1.18-2.82, P = .007); and PWVm (OR 1.53, 95% CI 1.07-2.19, P = .021) were independent factors for PVC loads.
Increased central aortic pressure indices as well as PWVm were associated with increased PVC loads in young patients undergoing 24-hour ambulatory electrocardiography. Central aortic properties probably contributed to the occurrence of PVC.
尽管室性早搏（PVC）频繁发生，但其诱发因素鲜有研究。我们研究了PVC与主动脉僵硬度之间的联系。
我们连续招募了200例患者（年龄<50岁，男性95例，平均年龄36±10岁），这些患者因心悸和PVC负荷接受了24小时动态心电图检查。测量了肌性动脉脉搏波速度（PWVm）和4个主要的主动脉压力指标——增强压力、增强指数（AI(x)）、校正心率稳定在75次/分钟时的AI(x)以及额外工作量，并评估了动脉粥样硬化风险。
83例（42%）患者无PVC负荷；58例（29%）患者负荷较低（<24次/天），59例（29%）患者负荷较高（≥24次/天）。仅年龄和高脂血症与PVC负荷显著相关。使用针对潜在混杂因素进行调整的多因素逻辑回归模型，我们发现AI(x)（比值比[OR]1.88，95%可信区间1.20 - 2.91，P = 0.005）；增强压力（OR 1.57，95%可信区间1.02 - 2.43，P = 0.042）；校正心率稳定在75次/分钟时的AI(x)（OR 1.82，95%可信区间1.18 - 2.82，P = 0.007）；以及PWVm（OR 1.53，95%可信区间1.07 - 2.19，P = 0.021）是PVC负荷的独立因素。
在接受24小时动态心电图检查的年轻患者中，中心主动脉压力指标升高以及PWVm升高与PVC负荷增加相关。中心主动脉特性可能促成了PVC的发生。
