Karaman Kayihan, Karayakali Metin, Arisoy Arif, Akar Ilker, Ozturk Mustafa, Yanik Ahmet, Yilmaz Samet, Celik Atac
Gaziosmanpasa University Faculty of Medicine, Department of Cardiology, Tokat - Turkey.
Gaziosmanpasa University Faculty of Medicine, Department of Cardiovascular Surgery, Tokat - Turkey.
Arq Bras Cardiol. 2018 Jun;110(6):534-541. doi: 10.5935/abc.20180079.
Ventricular premature contractions (VPCs) may trigger lethal ventricular arrhythmias in patients with structural heart disease. However, this role of VPCs in healthy people remains controversial once that not enough clinical trials are available. Recently, some myocardial repolarization markers, such as Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios, have been reported to be useful for predicting lethal ventricular arrhythmias in various clinical disorders without structural heart disease.
In this study, we aimed to investigate the relation between VPC frequent and myocardial repolarization markers in individuals without structural heart disease.
This study included 100 patients who had complaints of dizziness and palpitations. Twelve-lead electrocardiography and 24-hour ambulatory Holter recordings were obtained from all patients. VPC burden was calculated as the total number of VPCs divided by the number of all QRS complexes in the total recording time. P-values < 0.05 were considered significant.
Tp-e interval and Tp-e/QTc ratio were significantly higher in patients with higher VPC burden than in patients with lower VPC burden, and a positive correlation was found between these markers and VPC burden. Tp-e (β = 1.318, p = 0.043) and Tp-e/QTc (β = -405.136, p = 0.024) in the lead V5 were identified as independent predictors of increased VPC burden.
Tp-e interval and Tp-e/QTc ratio increased in patients with high VPC number. Our study showed that VPCs may have a negative effect on myocardial repolarization. This interaction may lead to an increased risk of malignant arrhythmias.
室性早搏（VPCs）可能会触发结构性心脏病患者的致命性室性心律失常。然而，由于缺乏足够的临床试验，VPCs在健康人群中的这一作用仍存在争议。最近，一些心肌复极标志物，如Tp-e间期、Tp-e/QT和Tp-e/QTc比值，已被报道可用于预测无结构性心脏病的各种临床疾病中的致命性室性心律失常。
在本研究中，我们旨在调查无结构性心脏病个体中VPC频率与心肌复极标志物之间的关系。
本研究纳入了100名有头晕和心悸主诉的患者。所有患者均进行了12导联心电图和24小时动态心电图记录。VPC负荷计算为VPC总数除以总记录时间内所有QRS波群的数量。P值<0.05被认为具有统计学意义。
VPC负荷较高的患者的Tp-e间期和Tp-e/QTc比值显著高于VPC负荷较低的患者，并且发现这些标志物与VPC负荷之间存在正相关。V5导联的Tp-e（β = 1.318，p = 0.043）和Tp-e/QTc（β = -405.136，p = 0.024）被确定为VPC负荷增加的独立预测因子。
VPC数量较多的患者的Tp-e间期和Tp-e/QTc比值升高。我们的研究表明，VPCs可能对心肌复极有负面影响。这种相互作用可能会导致恶性心律失常风险增加。
