Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro Gangnam-gu, Seoul, Republic of Korea.
Europace. 2018 Sep 1;20(FI2):f204-f210. doi: 10.1093/europace/eux170.
This study aimed to investigate if increased stroke volume (SV) after a ventricular premature complex (VPC) was related to VPC-related symptoms.
We selected patients having an isolated VPC during echocardiography from a prospective registry that included patients with a structurally normal heart and 24-h VPC >1%. Patients were divided into two groups according to the presence or absence of VPC-related symptoms (skipped beat or palpitation) when VPC occurred. Left ventricular (LV) volumes and time-velocity integral (TVI) at the LV outflow tract were measured during the preceding sinus beat, VPC, and post-ectopic sinus beat. Percent LV SV of the VPC and post-ectopic sinus beat were calculated by dividing each SV by the SV of the preceding sinus beat. A total of 47 patients were eligible. Most patients had VPC with left bundle branch block morphology and inferior axis. Patients in the symptom (+) group had a significantly lower SV, %LV SV, and TVI during post-ectopic sinus beat than those in the symptom (-) group. The sum of SVs during VPC and post-ectopic beat was significantly lower in symptomatic patients than non-symptomatic patients (103.4 mL vs. 125.1 mL, P = 0.02), while the sum of %LV SVs during VPC and post-ectopic beat tended to be lower in patients with symptoms than those without symptoms (P = 0.08). The sum of %LV SVs during VPC and post-VPC was positively correlated with coupling interval (CI) and CI ratio.
Ventricular premature complex-related symptoms may not be associated with the amount of post-VPC SV.
本研究旨在探讨室性早搏(VPC)后心搏量(SV)增加是否与 VPC 相关症状相关。
我们从一个前瞻性登记处中选择了在超声心动图检查期间发生孤立 VPC 的患者,该登记处包括结构正常的心脏和 24 小时 VPC > 1%的患者。根据 VPC 发生时是否存在 VPC 相关症状(漏搏或心悸),将患者分为两组。在窦性前心动周期、VPC 和异位窦后心动周期期间测量左心室(LV)容积和左心室流出道时间速度积分(TVI)。通过将每个 SV 除以窦性前心动周期的 SV 来计算 VPC 和异位窦后心动周期的 LV SV 百分比。共有 47 名患者符合条件。大多数患者的 VPC 具有左束支传导阻滞形态和下侧轴。症状(+)组的患者在异位窦后心动周期时的 SV、LV SV 百分比和 TVI 明显低于症状(-)组。在有症状的患者中,VPC 和异位后心动周期期间 SV 之和明显低于无症状患者(103.4 mL 比 125.1 mL,P = 0.02),而 VPC 和异位后心动周期期间 LV SV 百分比之和在有症状的患者中也趋于低于无症状患者(P = 0.08)。VPC 和异位后心动周期期间 LV SV 百分比之和与耦合间隔(CI)和 CI 比值呈正相关。
VPC 相关症状可能与 VPC 后 SV 量无关。