Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Heart Rhythm. 2011 Jul;8(7):1046-9. doi: 10.1016/j.hrthm.2011.02.034. Epub 2011 Mar 3.
Frequent premature ventricular complexes (PVCs) can cause cardiomyopathy. The mechanism is not known and may be multifactorial.
This study assessed the role of PVC interpolation in PVC-induced cardiomyopathy.
In 51 consecutive patients (14 women, age 49 ± 15 years, ejection fraction (EF) 0.49 ± 0.14) with frequent PVCs, 24-hour Holter recordings were performed. The amount of interpolation was determined and correlated with the presence of PVC-induced cardiomyopathy. In addition, parameters measured during an electrophysiology study were correlated with the Holter findings.
Fourteen of the 21 patients (67%) with cardiomyopathy had interpolated PVCs, compared with only 6 of 30 patients (20%) without PVC-induced cardiomyopathy (P <.001). Patients with interpolated PVCs had a higher PVC burden than patients without interpolation (28% ± 12% vs. 15% ± 15%; P = .002). The burden of interpolated PVCs correlated with the presence of PVC cardiomyopathy (21% ± 30% vs. 4% ± 13%; P = .008). Both PVC burden and interpolation independently predicted PVC-induced cardiomyopathy (odds ratio 1.07, 95% confidence interval 1.01 to 1.13, P = .02; and odds ratio 4.43, 95% confidence interval 1.06 to 18.48, P = .04, respectively). The presence of ventriculoatrial block at a ventricular pacing cycle length of 600 ms correlated with the presence of interpolation (P = .004). Patients with interpolation had a longer mean ventriculoatrial block cycle length than patients without interpolated PVCs (520 ± 110 ms vs. 394 ± 92 ms; P = .01).
The presence of interpolated PVCs was predictive of the presence of PVC cardiomyopathy. Interpolation may play an important role in the generation of PVC-induced cardiomyopathy.
频繁的室性早搏（PVC）可导致心肌病。其机制尚不清楚，可能是多因素的。
本研究评估了 PVC 插入在 PVC 诱导性心肌病中的作用。
在 51 例连续的频发 PVC 患者（14 例女性，年龄 49±15 岁，射血分数（EF）0.49±0.14）中进行 24 小时动态心电图记录。确定插入的数量，并与 PVC 诱导性心肌病的存在相关。此外，还对电生理研究期间测量的参数与动态心电图结果进行了相关性分析。
21 例心肌病患者中有 14 例（67%）存在插入性 PVC，而无 PVC 诱导性心肌病的 30 例患者中只有 6 例（20%）（P<.001）。存在插入性 PVC 的患者的 PVC 负荷高于无插入的患者（28%±12%比 15%±15%；P=.002）。插入性 PVC 的负荷与 PVC 心肌病的存在相关（21%±30%比 4%±13%；P=.008）。PVC 负荷和插入均独立预测 PVC 诱导性心肌病（优势比 1.07，95%置信区间 1.01 至 1.13，P=.02；和优势比 4.43，95%置信区间 1.06 至 18.48，P=.04）。在心室起搏周期长度为 600 ms 时存在室房阻滞与存在插入相关（P=.004）。存在插入性 PVC 的患者的平均室房阻滞周期长度长于无插入性 PVC 的患者（520±110 ms 比 394±92 ms；P=.01）。
存在插入性 PVC 可预测存在 PVC 心肌病。插入可能在 PVC 诱导性心肌病的发生中起重要作用。
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