Hasdemır Can, Kartal Yıldırım, Sımsek Evrım, Yavuzgıl Oguz, Aydın Mehmet, Can Levent H
Department of Cardiology, Ege University School of Medicine, Izmir, Turkey.
Pacing Clin Electrophysiol. 2013 May;36(5):612-7. doi: 10.1111/pace.12087. Epub 2013 Feb 4.
Idiopathic ventricular arrhythmias in the form of frequent, monomorphic premature ventricular contractions (PVC) can cause PVC-induced cardiomyopathy (PICMP). The aim of this study was to determine the baseline echocardiographic characteristics and the time course and degree of recovery of left ventricular (LV) systolic dysfunction in patients with PICMP.
Study population consisted of 348 consecutive patients (205F/143M, 44 ± 19 y/o) with frequent PVCs and/or ventricular tachycardia. PICMP was defined as LV ejection fraction (LVEF) of <55% in the absence of any detectable underlying heart disease and improvement of LVEF ≥ 15% following treatment of ventricular arrhythmia. Patients with PCIMP underwent transthoracic echocardiography for LV size and function at 1 week and at 1-3 to 6-12 months of follow-up.
Twenty-four patients (8F/16M, 47 ± 18 y/o) with PICMP with complete echocardiographic data were included in the study. Average baseline LV end-diastolic diameter, LV end-systolic volume, LV mass index, and LVEF were 55.4 ± 6.8 mm, 69.6 ± 23.3 mL, 110.2 ± 28.3 g/m2, and 41 ± 8.4%, respectively. Mild-to-moderate mitral regurgitation (MR) was present in 13 (54%) patients. Early improvement (≥25% increase in LVEF at 1-week follow-up compared to baseline) was observed in 13 (54%) patients. Patients with early improvement had higher LVEF at 12 months of follow-up compared to patients without early improvement (58.8 ± 5.0% vs 52.5 ± 6.7%, P = 0.019).
PCIMP is characterized by mild-to-moderate global LV systolic dysfunction with slightly increased LV mass and mild-to-moderate MR. Greatest improvement in LV systolic dysfunction was observed at 1-week follow-up in our study population. Early improvement in LVEF may potentially predict the complete reversibility of LV systolic dysfunction.
以频发、单形性室性早搏（PVC）形式出现的特发性室性心律失常可导致PVC诱发的心肌病（PICMP）。本研究的目的是确定PICMP患者的基线超声心动图特征以及左心室（LV）收缩功能障碍的恢复时间过程和程度。
研究人群包括348例连续的频发PVC和/或室性心动过速患者（205例女性/143例男性，44±19岁）。PICMP定义为在无任何可检测到的潜在心脏病情况下左心室射血分数（LVEF）<55%，且在室性心律失常治疗后LVEF改善≥15%。患有PCIMP的患者在1周以及随访1至3个月至6至12个月时接受经胸超声心动图检查以评估左心室大小和功能。
本研究纳入了24例具有完整超声心动图数据的PICMP患者（8例女性/16例男性，47±18岁）。平均基线左心室舒张末期直径、左心室收缩末期容积、左心室质量指数和LVEF分别为55.4±6.8mm、69.6±23.3mL、110.2±28.3g/m2和41±8.4%。13例（54%）患者存在轻至中度二尖瓣反流（MR）。13例（54%）患者观察到早期改善（与基线相比，1周随访时LVEF增加≥25%）。与未早期改善的患者相比，早期改善的患者在随访12个月时LVEF更高（58.8±5.0%对52.5±6.7%，P = 0.019）。
PCIMP的特征是左心室整体轻至中度收缩功能障碍，左心室质量略有增加，以及轻至中度MR。在我们的研究人群中，左心室收缩功能障碍在1周随访时改善最为明显。LVEF的早期改善可能潜在地预测左心室收缩功能障碍的完全可逆性。
