Kim Yong-Hyun, Park Seong-Mi, Lim Hong Euy, Pak Hui-Nam, Kim Young-Hoon, Shim Wan-Joo
Division of Cardiology, Department of Medicine, Korea University Anam Hospital, Seoul, Republic of Korea.
Int Heart J. 2010;51(6):388-93. doi: 10.1536/ihj.51.388.
Frequent premature ventricular complexes (PVCs) from the right ventricular outflow tract (RVOT) have recently been reported to be a cause of dilated cardiomyopathy. We studied the clinical impact of the elimination of PVCs from RVOT and non-RVOT.Thirty-six patients with symptomatic PVCs that were treated with radiofrequency catheter ablation (RFCA) were studied. The patients were assigned to one of two groups according to the origin of the PVCs (group I, RVOT-origin, n = 24; group II, non-RVOT-origin, n = 12) and observed for 10.5 ± 7.1 months.The burden of PVCs at baseline was 19.7 ± 10.6% and 18.7 ± 8.7% in group I and group II, respectively (P = 0.779). In group II, hypertension was more common (16.7% versus 58.3%, P = 0.020) and LV diastolic function was worse (Em, 8.7 ± 3.0 versus 6.4 ± 1.8 cm/second, P = 0.018). The LV end diastolic volume index (LVEDVI) decreased in both groups (59.7 ± 14.6 to 50.9 ± 9.6 mL/m(2), P = 0.004 in group I; 60.0 ± 19.9 to 51.6 ± 12.4 mL/m(2), P = 0.044 in group II), while the left atrial volume index (LAVI) decreased only in group I (36.7 ± 11.7 to 31.7 ± 10.0 mL/m(2), P = 0.002 in group I; 35.6 ± 11.9 to 33.8 ± 10.3 mL/m(2), P = 0.317 in group II). The left ventricular ejection fraction (LVEF) significantly improved in both groups (51.1 ± 6.6 to 59.8 ± 7.2 %, P < 0.01 in group I; 49.9 ± 6.9 to 59.0 ± 5.9 %, P < 0.01 in group II).RFCA of PVCs leads to a reduction of LV volume and improvement of LV systolic function regardless of the origin of the PVCs. Conversely, a non-RVOT-origin as well as an RVOT-origin of the PVCs can cause DCM-like changes in the left ventricle.
最近有报道称，右心室流出道（RVOT）频发室性早搏（PVCs）是扩张型心肌病的一个病因。我们研究了消除RVOT和非RVOT来源的PVCs对临床的影响。
对36例有症状的PVCs患者进行了射频导管消融（RFCA）治疗并进行研究。根据PVCs的起源将患者分为两组（I组，RVOT起源，n = 24；II组，非RVOT起源，n = 12），并观察10.5±7.1个月。
I组和II组基线时PVCs的负荷分别为19.7±10.6%和18.7±8.7%（P = 0.779）。在II组中，高血压更为常见（16.7%对58.3%，P = 0.020），左心室舒张功能更差（Em，8.7±3.0对6.4±1.8 cm/秒，P = 0.018）。两组的左心室舒张末期容积指数（LVEDVI）均下降（I组从59.7±14.6降至50.9±9.6 mL/m²，P = 0.004；II组从60.0±19.9降至51.6±12.4 mL/m²，P = 0.044），而左心房容积指数（LAVI）仅在I组下降（I组从36.7±11.
